Continuous southwestward spread of Fukushima-derived 137Cs in the subtropical western North Pacific and its intrusion flux into the South China Sea

We provide transect profiles of 137Cs and 90Sr along 146.5°E, 136°E and 21°N in the subtropical western North Pacific (WNP) during May 2018. Exploiting the constant global fallout 137Cs/90Sr ratio, we separated Fukushima-derived 137Cs (137CsF) from background 137Cs. At most stations, 137CsF exhibited only one subsurface peak at 300 m depth, corresponding to subtropical mode water (STMW); however, at 25-28°N along 146.5°E and 25-26°N along 136°E, 137CsF exhibited two subsurface peaks, with another peak occurring at 500 m depth, corresponding to lighter central mode water (L-CMW). Temporal changes in 137CsF vertical profiles showed that 137CsF entrained by STMW has recirculated within the western subtropical gyre, while 137CsF entrained by L-CMW has turned southwestward and arrived the western basin in 2018. In the Luzon Strait, the entrance to the South China Sea (SCS), subsurface 137Cs increased since 2013 and peaked in approximately 2018. The estimated amount of 137CsF entering the SCS during 2013-2019 was 0.33 ± 0.10 PBq, equivalent to 1.7-2.2% of total leakage of 137CsF into the ocean. These results enhance our understanding of the protracted spread and fate of 137CsF in the subtropical WNP.

Highly efficient capture of iodine vapor by [Mo3S13]2- intercalated layered double hydroxides

From the swollen LDH, bulky [Mo3S13]2- anions are facilely introduced into the LDH interlayers to assemble the Mo3S13-LDH composite, which exhibits excellent iodine capture performance and good irradiation resistance. The positive-charged LDH layers may disperse the [Mo3S13]2- uniformly within the interlayers, providing abundant adsorption sites for effectively trapping iodine. The Mo-S bond serving as a soft Lewis base has strong affinity to I2 with soft Lewis acidic characteristic, which is conducive to improvement of iodine capture via physical sorption. Besides, chemisorption has a significant contribution to the iodine adsorption. The S22-/S2- in [Mo3S13]2- can reduce the I2 to [I3]- ions, which are facilely fixed within the LDH gallery in virtue of electrostatic attraction. Meanwhile, the S22-/S2- themselves are oxidized to S8 and SO42-, while Mo4+ is oxidized (by O2 in air) to Mo6+, which combines with SO42- forming amorphous Mo(SO4)3. With the collective interactions of chemical and physical adsorption, the Mo3S13-LDH demonstrates an extremely large iodine adsorption capacity of 1580 mg/g. Under γ radiation, the structure of Mo3S13-LDH well maintains and iodine adsorption capability does not deteriorate, indicating the good irradiation resistance. This work provides an important reference to tailor cost-effective sorbents for trapping iodine from radioactive nuclear wastes.

KIF3C: an emerging biomarker with prognostic and immune implications across pan-cancer types and its experiment validation in gastric cancer

Kinesin Family Member 3C (KIF3C) assumes a crucial role in various biological processes of specific human cancers. Nevertheless, there exists a paucity of systematic assessments pertaining to the contribution of KIF3C in human malignancies. We conducted an extensive analysis of KIF3C, covering its expression profile, prognostic relevance, molecular function, tumor immunity, and drug sensitivity. Functional enrichment analysis was also carried out. In addition, we conducted in vitro experiments to substantiate the role of KIF3C in gastric cancer (GC). KIF3C expression demonstrated consistent elevation in various tumors compared to their corresponding normal tissues. We further unveiled that heightened KIF3C expression served as a prognostic indicator, and its elevated levels correlated with unfavorable clinical outcomes, encompassing reduced OS, DSS, and PFS in several cancer types. Notably, KIF3C expression exhibited positive associations with the pathological stages of several cancers. Moreover, KIF3C demonstrated varying relationships with the infiltration of various distinct immune cell types in gastric cancer. Functional analysis outcomes indicated that KIF3C played a role in the PI3K-AKT signaling pathway. Drug sensitivity unveiled a positive relationship between KIF3C in gastric cancer and the IC50 values of the majority of identified anti-cancer drugs. Additionally, KIF3C knockdown reduced the proliferation, migration, and invasion capabilities, increased apoptosis, and led to alterations in the cell cycle of gastric cancer cells. Our research has revealed the significant and functional role of KIF3C as a tumorigenic gene in diverse cancer types. These findings indicate that KIF3C may serve as a promising target for the treatment of gastric cancer.

[Effect of dual fluorescence imaging in identifying central lymph nodes and parathyroid glands during thyroid cancer surgery]

Objective: To investigate the effect of dual fluorescence imaging in identifying central lymph nodes and parathyroid glands during thyroid cancer surgery. Methods: This study was a cross-sectional study. Patients who underwent surgery for papillary thyroid cancer (PTC) at the Department of Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University between January 2022 and September 2023 were included. All patients underwent thyroid lobectomy or total resection, and central lymph node dissection was performed at the same time. During the operation, tracing injection of mitoxantrone hydrochloride and 785 nm and 660 nm dual fluorescence imaging technique were used to measure the fluorescence intensity (FI) of parathyroid glands, central lymph nodes and background. After correcting to obtain the standardized FI, the paired t-test was used to compare the standardized FI of the parathyroid glands and central lymph nodes, and the Spearman's rank correlation analysis was used to analyze the relationship between the standardized FI and various clinical indicators. Results: The study included 30 patients (8 males and 22 females), with a mean age of (41.8±10.4) years. A total of 76 parathyroid glands and 234 central lymph nodes were identified under dual fluorescence imaging, and the standardized FI of parathyroid glands was less than that of central lymph nodes (44.7±16.8 vs 99.5±28.4, P<0.001). The visualization rate, false rate and miscut rate of parathyroid glands under 785 nm wavelength excitation light were 98.7% (76/77), 0 (0/77) and 1.3% (1/77), respectively (one case with no visualization and miscutting parathyroid gland was the encapsulated type). The visualization rate of central lymph nodes under 660 nm wavelength excitation light was 98.7% (234/237). There was no significant correlation between FI and clinical indicators such as gender, age, height, weight, body mass index, preoperative thyroid stimulating hormone, thyroglobulin antibody, thyroid microsomal antibody, serum calcium, parathyroid hormone level and surgical procedure (all P>0.05). Conclusion: Dual fluorescence imaging of central lymph nodes and parathyroid glands can improve the ability to identify parathyroid gland while assisting central lymph node dissection.

Surfactant-like Additives Assisted the Lateral Growth of Pentacene Films

Lateral growth of thin films is crucial for organic electronic devices, such as field-effect transistors. Here, we report a strategy to improve the lateral growth of pentacene films using rubrene as a surfactant-like additive. Atomic force microscopy (AFM) images confirm the enhanced lateral growth with the presence of rubrene, resulting in smooth and enlarged molecule domains in the films in comparison to those without rubrene. Molecular dynamics simulations are conducted to explore the interlayer diffusion of pentacene molecules during the growth. With the rubrene molecules as surfactant-like additives, mean square displacement (MSD) analysis shows that the pentacene molecules have a descending diffusion coefficient of 2.0 × 10-5 cm2 s-1, which is greater than the ascending diffusion coefficient of 1.6 × 10-5 cm2 s-1. The more descending molecules lead to an enhanced lateral growth of pentacene films, which is in good agreement with the experiments. As a result, the pentacene films grown with rubrene exhibit a rapid increase in carrier mobility over thickness due to the well-connected domains resulting from enhanced lateral growth. This finding will provide a new strategy to modulate the morphology of organic films for high-performance devices.

Characterizing 226Ra and its daughters in coastal zone groundwater of a typical human-activity affected bay: occurrence, safety, and source evaluation

Due to their extremely toxic properties, 226Ra and it daughters (222Rn, 210Pb, and 210Po) in drinking groundwater require monitoring. Recent studies have reported exceptionally high levels of natural 210Po (up to 10,000 Bq/m3), 226Ra, and 222Rn isotopes in groundwater. This study aims to provide background data on 226Ra and its daughter radionuclides in the typical agricultural-industrial Dongshan Bay (DSB) before the construction of Zhangzhou Nuclear Power Plant (Zhangzhou NPP). The measurement results indicate that no abnormally high activities of 210Po and 210Pb were detected in the investigated wells. Strong positive correlations between 210Pb and 210Po, as well as between 222Rn and 210Pb activities, suggest that the origins of 210Pb and 210Po in groundwater are strongly influenced by the decay of the parent radionuclides 222Rn and 210Pb, respectively. In the DSB coastal zone groundwater, significant deficiencies of 210Po relative to 210Pb and 210Pb relative to 222Rn were observed, providing further evidence that 210Po and 210Pb are also effectively scavenged due to their geochemical properties (specifically particle affinity) within the groundwater-aquifer system. A systematic comparison among all relevant water bodies in the DSB revealed that the activity concentrations of 210Pb and 210Po in groundwater were the highest, except for rainwater. Based on the evaluation of 210Pb sources, the results imply that submarine groundwater discharge (SGD) is an important pathway for transferring radionuclides (such as 210Pb) from land to the nearshore marine environment, even though the study area has a lower 210Pb background groundwater. By considering all the 210Pb's sources in the DSB, we found low 210Pb background groundwater discharge still needs to be taken into account for small-scale bays. This is because SGD was calculated to be one of the most important 210Pb sources in the bay during observation season. Regardless of whether the system is in a normal state or a nuclear accident emergency state, greater attention should be paid to the groundwater discharge of radionuclides into the ocean.

Geochemical Distribution and Environmental Risks of Radionuclides in Soils and Sediments Runoff of a Uranium Mining Area in South China

Uranium mining activities have contributed to the distribution and uptake of radionuclides, which have increased the active concentrations of natural radionuclides in environmental media, causing elevated human health risks. The present study aims to assess the spatial distribution characteristics of natural radionuclides in the surface soils and river sediments of the typical granite uranium mining area in South China, as well as investigate the geochemical features of natural radionuclides in the soil and sediments to understand their migration processes. The activity concentrations for 238U, 226Ra, 232Th, and 40K ranged from 17-3925 Bq/kg, 50-1180 Bq/kg, 29-459 Bq/kg, and 240-1890 Bq/kg, respectively. The open-pit mining areas and tailings pond locations exhibited the highest concentrations of activity for all these radionuclides. This distribution points to an elevated potential health risk due to radiological exposure in these specific areas. Additionally, the values of radium equivalent activity (Raeq) and annual gonadal dose equivalent (AGDE) in those areas were higher than the limits recommended by ICRP (2021). 238U and 226Ra have a significant correlation (0.724), and the cluster analysis was showing a statistically meaningful cluster below 5 indicated that they have similar behavior during parent rock weathering and watershed erosion, and the distribution of 232Th and 40K were influenced by the addition of rock types. The activity ratios of 226Ra/238U, 226Ra/232Th, 238U/40K, and 226Ra/40K variation indicated that 40K more mobile than 226Ra and 238U, U(VI) was reduced to U(IV) by organic matter in the downstream area and re-entered into the sediment during the sediment surface runoff in the small watershed of the uranium ore open-pit mining area. Therefore, it is necessary to further seal up and repair the tailings landfill area.

Identification and validation of INHBE and P4HA1 as hub genes in non-alcoholic fatty liver disease

PURPOSE

Non-alcoholic fatty liver disease (NAFLD) is currently the most prevalent type of liver disease and a worldwide disease threatening human health. This study aims to identify the novel diagnostic biomarkers of NAFLD by comprehensive bioinformatics and machine learning, and to validate our results in hepatocyte and animal models.

METHODS

We used Gene Expression Omnibus (GEO) databases on NAFLD patients for differential gene expression analyses. Intersections were taken with genes from the key modules of WGCNA and differentially expressed genes (DEGs). Machine learning algorithms like LASSO regression analysis, SVM-RFE, and RandomForest were used to screen hub genes. In addition, a nomogram model and calibration curves were built in order to forecast the probability of NAFLD occurrence. Then, the relationship between hub genes and immune cells was verified using Spearman analysis. Finally, we further verified the expression of key genes by constructing a steatosis hepatocyte model and animal model.

RESULTS

Key genes (INHBE and P4HA1) were identified by comprehensive bioinformatics analysis and machine learning. INHBE and P4HA1 were up-regulated and down-regulated in the steatosis hepatocyte model, respectively. Animal experiments also showed that INHBE was up-regulated in the liver of mice fed with high fat diet (HFD).

CONCLUSION

INHBE and P4HA1 are the hub genes of NAFLD. Our findings may contribute to a greater understanding of the occurrence and development of NAFLD and provide potential biomarkers and possible therapeutic targets for future clinical diagnosis and treatment.

[Establishment of a nomogram prediction model using common preoperative indicators for early weight loss after laparoscopic sleeve gastrectomy]

Objectives: To construct a nomogram prediction model using common preoperative indicators for early weight loss (EWL) 1 year after laparoscopic sleeve gastrectomy (LSG). Methods: Relevant data of obese patients who had undergone LSG from January 2015 to May 2022 in Fujian Medical University Union Hospital and Quanzhou First Hospital Affiliated Fujian Medical University were analyzed. Patients with a history of major abdominal surgery, severe gastroesophageal reflux disease, pregnancy within 1 year after surgery, or who were lost to follow-up were excluded, resulting in a total of 200 patients in the study (190 from Fujian Medical University Union Hospital and 10 from Quanzhou First Hospital Affiliated Fujian Medical University). The participants were 51 men and 149 women of a mean age 29.9±8.2 years and a body mass index (BMI) 38.7±6.5 kg/m2. All patients in this group underwent standardized LSG procedure. Achieving ideal weight (BMI≤25 kg/m2) 1 year after LSG was defined as goal of EWL. Logistic regression analyses were performed to identify factors that independently influenced EWL. These factors were incorporated into the nomogram model. Receiver operating characteristic (ROC) curves (the larger the area under the curve [AUC], the better the predictive ability and accuracy of the model), likelihood ratio test (higher likelihood ratio indicates greater model homogeneity), decision curve analysis (higher net benefit indicates a better model), Akaike information criterion (AIC; smaller AIC indicates a better model), and Bayesian information criterion (BIC; smaller BIC indicates a better model) were used to validate the predictive ability of the column line diagram model. Results: In this study of 200 obese patients who underwent LSG surgery, 136 achieved EWL goal, whereas the remaining 64 did not. The rate of EWL goal achievement of the entire group was 68.0%. Compared with patients who did not achieve EWL goal, those who did had lower BMI, alanine transaminase, aspartate transaminase, triglycerides, and higher cholesterol. Additionally, the proportion of female was higher and the proportions of patients with fatty liver and hypertension lower in those who achieved EWL goal (all P<0.05). Univariate and multivariate logistic regression analysis revealed that preoperative BMI (OR=0.852, 95%CI: 0.796-0.912, P<0.001), alanine transaminase (OR=0.992, 95%CI: 0.985-0.999, P=0.024), presence of fatty liver (OR=0.185, 95%CI: 0.038-0.887, P=0.035) and hypertension (OR=0.374, 95%CI: 0.144-0.969, P=0.043) were independently associated with failure to achieve EWL goal. Cholesterol (OR=1.428, 95%CI: 1.052-1.939, P=0.022) was independently associated with achieving EWL goal. We used the above variables to establish an EWL nomogram model. ROC analysis, the likelihood ratio test, decision curve analysis, and AIC all revealed that the predictive value of the model was better than that of BMI alone (nomogram model vs. BMI: area under the curve 0.840 vs. 0.798, P=0.047; likelihood ratio: 58.785 vs. 36.565, AIC: 193.066 vs. 207.063, BIC: 212.856 vs. 213.660). Conclusion: Our predictive model is more accurate in predicting EWL after LSG compared with using BMI.

[Preliminary analysis of neuroprotective effects of capillary fascia preservation recurrent laryngeal nerve anatomical method in right level Ⅵ dissection]

Objective: To investigate the application and effect of capillary fascia preservation between the recurrent laryngeal nerve (RLN) and common carotid artery (fascia preservation method) in nerve protection when dissecting right level Ⅵ lymph nodes for patients with papillary thyroid carcinoma. Methods: A retrospective cohort study enrolling 195 patients with papillary thyroid carcinoma undergoing right level Ⅵ lymph node dissection in Beijing Tongren Hospital from March 2021 to August 2022 was carried out. The RLN was dissected by fascia preservation method in study group and by routine method in control group. The intraoperative electrical signal amplitude of the RLN, the number of dissected lymph nodes, and the postoperative complications were recorded and analyzed. Results: A total of 195 patients (study group: 94 cases, control group: 101 cases) were collected. There were 71 males and 124 females, with the median age of 32 (39, 51) years. In the study group, the total number of right level Ⅵ lymph nodes was significantly larger than the number of right Ⅵa level lymph nodes [8 (6, 11) vs 6 (4, 8), P<0.001]. There were no significant differences between the two groups in the number of level Ⅵa or level Ⅵb lymph nodes [Ⅵa: 6 (4, 8) vs 5 (3, 7), P=0.373; Ⅵb: 3 (1, 4) vs 2 (1, 4), P=0.337] and metastasis rate [Ⅵa: 51.1% (48/94) vs 52.5% (53/101), P=0.844; Ⅵb: 12.8% (12/94) vs 15.8% (16/101), P=0.541]. The ratio of electromyography (EMG) amplitude R2 in lower level Ⅵ and entry into larynx (grouped as>90%, 50%~90%,<50%) in the study group was significantly higher than that in the control group (P<0.001). No significant differences were detected between the two groups in temporary RLN paralysis [1.1% (1/94) vs 2.0% (2/101), P=1.000]. Conclusions: Fascia preservation method can decrease the stimulus and traction to RLN and preserve the capillary network serving RLN. It can thoroughly dissect lymph nodes and decrease the injury of RLN.

[Application of near-infrared autofluorescence imaging-based convolution neural network in recognition of parathyroid gland]

Objective: To investigate the application value of near-infrared autofluorescence imaging-based convolution neural network (CNN) for automatic recognition of parathyroid gland. Methods: The data of 83 patients who underwent thyroid papillary cancer surgery in the Department of Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University from August 2020 to March 2022 were retrospectively analyzed, and a total of 725 autofluorescence images of parathyroid gland were collected during the surgery. Meanwhile, non-parathyroid fluorescence imaging videos in the operation area of 10 patients were also collected, and 928 non-parathyroid fluorescence images were captured from those videos. The fluorescence images of parathyroid and non-parathyroid glands were directly used as input features for deep learning to construct ResNet 34, VGGNet 16 and GoogleNet models for automatic parathyroid identification. The ability of different models to identify parathyroid glands was tested by indicators such as accuracy, specificity, sensitivity, precision, receiver operating characteristic curve and area under the curve (AUC). In addition, 30 fluorescence images of parathyroid and 35 fluorescence images of non-parathyroid glands in 13 patients with papillary thyroid cancer from March to May 2022 were collected to prospectively test the best performing CNN model. Results: Among the 83 patients, there were 25 males and 58 females, with the mean age of (46.7±12.4) years. In the binary classification (parathyroid gland and non-parathyroid gland), the ResNet 34 model performed the best in different CNN models, the accuracy, specificity, sensitivity and precision of the identification test set were 97.6%, 96.3%, 99.3% and 95.5%, and the AUC reached 0.978 (95%CI: 0.956-0.991). In the prospective test, the prediction accuracy of the ResNet 34 model reached 93.8%, and the AUC was 0.938 (95%CI: 0.853-0.984). Conclusion: The near-infrared autofluorescence imaging-based deep CNN has good application value in the automatic recognition of parathyroid gland, and can be used to assist the recognition and protection of parathyroid gland in thyroid cancer surgery.

Lymphocyte Count Kinetics and the Effect of Different Radiotherapy Techniques on Radiation-Induced Lymphopenia in Patients with Breast Cancer Receiving Hypofractionated Postmastectomy Radiotherapy

PURPOSE/OBJECTIVE(S)

Radiation-induced lymphopenia (RIL) is associated with poor prognosis in solid tumors. This study aimed to describe the lymphocyte kinetics in patients with breast cancer receiving hypofractionated postmastectomy radiotherapy (RT) and to investigate the association of different RT techniques with RIL.

MATERIALS/METHODS

We assessed 607 patients who received hypofractionated postmastectomy RT for breast cancer in our prospective clinical database from 8 hospitals. All patients received irradiation to the chest wall and supraclavicular fossa. RT techniques included integrated RT with the photon-based intensity modulated techniques to irradiate all target volumes (integrated RT) and a hybrid approach combining photon irradiation to supraclavicular nodes and electron irradiation to the chest wall (hybrid RT). Peripheral lymphocyte counts (PLC) were tested prior to RT (baseline), weekly during RT, at 1, 2 weeks, 3, 6 months after RT, and then every 6 months. Grade 3+ RIL was defined as PLC nadir during RT of <0.5 ×103/ml. Mean PLC was compared by the t test. Univariate, multivariate, and propensity score matching (PSM) analyses were used to evaluate the effect of different RT techniques on grade 3+ RIL.

RESULTS

During RT, 121 (19.9%) of patients had grade 3+ RIL. The PLC started to recover at 1 week and reached baseline levels 1 year after RT. A greater proportion of the patients treated with the integrated RT (90/269, 33.5%) developed grade 3+ PLC compared with those receiving hybrid RT (31/338, 9.2%, P < 0.001). After conducting PSM, multivariate analyses showed lower baseline PLC (HR = 0.15, P<0.001) and RT technique (the integrated RT vs. hybrid RT, HR = 4.76, P<0.001) were independent risk factors for grade 3+ RIL. The PLC in patients receiving the integrated RT after RT were higher than that in those receiving hybrid RT (p<0.05).

CONCLUSION

RT technique affect the risk of and recovery from RIL, which may impact survival. Choosing appropriate RT technique to minimize RIL might be considered to benefit their outcomes.

Dose-Volume Predictors for Radiation Esophagitis in Breast Cancer Patients Undergoing Hypofractionated Regional Nodal Radiotherapy

PURPOSE/OBJECTIVE(S)

Radiation esophagitis (RE) is often overlooked in breast cancer radiotherapy. This study aimed to assess the incidence and dose-volume predictors of RE in breast cancer patients undergoing hypofractionated regional nodal irradiation (RNI).

MATERIALS/METHODS

Eligible patients were included who received intensity-modulated radiotherapy (RT) at the chest wall, the supraclavicular/infraclavicular fossa, level II axilla, and/or the internal mammary chain after mastectomy. The prescribed dose was 43.5 Gy in 15 fractions. The dose constraint for the esophagus was maximum dose <48 Gy. RE was evaluated weekly during RT and at 1 and 2 weeks, followed by 3 and 6 months after RT, and was graded according to the Common Toxicity Criteria for Adverse Events v3.0. The esophagus was contoured from the lower border level of the cricoid cartilage to the lower margin of the aortic arch. Esophageal total volume, mean dose (Dmean), maximum dose (Dmax), and the relative and absolute volumes receiving at least 5-45 Gy by 5 Gy increments (RV5-RV45 and AV5-AV45) were evaluated. Univariable and multivariable logistics regression analyses were performed to determine risk factors for RE, and receiver operating characteristic curves were obtained to identify the thresholds of esophageal dosimetric parameters.

RESULTS

In total, 298 patients were included between May 8, 2020 and January 5, 2022 (minimum post-RT follow-up: 6 months). A total of 153 (51.3%) patients had left-sided breast cancer and 145 (48.7%) patients received internal mammary nodal irradiation (IMNI). Grade 2 and 3 RE incidence was 40.9% (122/298) and 0.3% (1/298), respectively. No grade 4 or 5 RE was observed. All RE cases resolved within 1 month after RT, and the median duration of RE was 3 weeks (range, 1-5). Based on univariable analyses, tumor laterality (p < .001), IMNI (p = .056) and esophageal Dmean, Dmax, RV10-RV40, and AV10-AV40 were risk factors of ≥grade 2 RE. Esophageal RV10-RV40 and AV35-AV40 were significantly associated with the risk of ≥grade 2 RE after adjusting for tumor laterality and IMNI. Based on multivariable analyses, RV25 and AV35 were optimum dose-volume predictors for ≥grade 2 RE at thresholds 20% for RV25 (35.9% vs. 60.9%, p = .04) and 0.27 mL for AV35 (31.0% vs. 54.6%, p = .04).

CONCLUSION

RE is common in breast cancer patients undergoing hypofractionated RNI. With the same esophageal contouring standard, maintaining the upper esophageal V25 at <20% and V35 at <0.27 mL may decrease the risk of RE and improve the quality of life of patients.

Quality Assurance in a Phase III, Multicenter, Randomized Trial of POstmastectomy radioThErapy in Node posiTive Breast Cancer with or without Internal mAmmary nodaL Irradiation (POTENTIAL): A Planning Dummy Run

PURPOSE/OBJECTIVE(S)

To report the planning dummy run results of the POstmastectomy radioThErapy in Node posiTive breast cancer with or without Internal mAmmary nodaL irradiation (POTENTIAL) trial-a multicenter, randomized, phase 3 trial-to evaluate postmastectomy radiotherapy, with or without internal mammary nodal irradiation, for patients with high-risk breast cancer.

MATERIALS/METHODS

All participating institutions were provided the contours of the dummy run case, and they generated radiotherapy (RT) plans per protocol guidelines. The plans were reviewed and feedback were provided by the quality assurance team, after which the institutions resubmitted revised plans. The information on beams arrangement, skin flash, inhomogeneity corrections, and protocol compliance was assessed both in the primary and final submission.

RESULTS

Theplans from 26 institutions were included in the analysis. A number of major deviations were found in the primary submission, such as less strict constraint on organs at risk (OARs) V5Gy, and no application of chest wall skin flash. The protocol compliance rates of the dose coverage for the planning target volume of the chest wall (PTVcw), PTV of supra/infraclavicular fossa plus axilla levels I, II, III (PTVsc+ax), and PTV of the IMN region (PTVim) were all significantly improved in the final submission compared with those in the primary submission, which were 96.2% vs. 69.2%, 100% vs. 76.9%, and 88.4% vs. 53.8, respectively. For OARs, the protocol compliance rates of heart Dmean, left anterior descending coronary artery V40Gy, ipsilateral lung V5Gy, and stomach V5Gy were significantly improved.

CONCLUSION

All major deviations were corrected and protocol compliance was significantly improved and of high level in the final submission. Moreover, the variations were reduced. Therefore, a planning dummy run was essential to guarantee good RT plan quality and inter-institutional consistency for multicenter trials.

Association of Treatment Disparities and Primary Sites with the Survival of Non-Gastric Early-Stage MALT Lymphoma

PURPOSE/OBJECTIVE(S)

To investigate the association between utilization of radiotherapy and differences in survival among patients with non-gastric early-stage mucosa-associated lymphoid tissue (MALT) lymphoma at different primary sites.

MATERIALS/METHODS

A total of 5,995 patients with non-gastric early-stage MALT lymphoma in the Surveillance, Epidemiology, and End Results (SEER) database treated between 2000-2015 were extracted and analyzed. Mediation analyses were conducted to quantitatively determine the proportion of the relationship between OS and primary sites mediated by radiotherapy. Inverse probability of treatment weighting (IPTW) was conducted to control confounding factors affecting treatment choice.

RESULTS

After controlling for confounding factors, pulmonary MALT lymphoma was found to have the highest rate of omitted radiotherapy compared to other primary sites, including ocular adnexa, salivary gland, skin and other sites. Multivariate Cox analyses showed that lung MALT lymphoma patients had the lowest 10-year OS rate of 58.3%, while skin MALT lymphoma patients had the highest 10-year OS rate of 81.6%. After balancing confounding factors that potentially affected the choice of radiotherapy using IPTW, differences in utilization of radiotherapy explained a significant portion of the poor prognosis of lung MALT lymphoma (35.6%, P = 0.002) and the favorable prognosis of skin MALT lymphoma (6.1%, P <0.001).

CONCLUSION

Differences in survival among patients with non-gastric early-stage MALT lymphoma at different primary sites are associated with disparities in the utilization of radiotherapy.

Geochemical distributions of natural radionuclides in surface soils and sediments impacted by lead-zinc mining activity

This study investigated the distribution features of uranium-238 (238U), radium-226 (226Ra), thorium-232 (232Th), and potassium-40 (40K) and evaluated the associated environmental radiological hazards of the topsoil and river sediments in the Jinding lead-zinc (Pb-Zn) mine catchment from Southwest China. The activity concentrations of 238U, 226Ra, 232Th, and 40K ranged from 24.0 ± 2.29-60.3 ± 5.26 Bq.kg-1, from 32.5 ± 3.95-69.8 ± 3.39 Bq.kg-1, from 15.3 ± 2.24-58.3 ± 4.92 Bq.kg-1, and from 203 ± 10.2-1140 ± 27.4 Bq.kg-1, respectively. The highest activity concentrations for all these radionuclides were primarily found in the mining areas and decreased with increasing distance from the mining sites. The radiological hazard indices, including radium equivalent activity, absorbed gamma dose rate in the air, outdoor annual effective dose equivalent, annual gonadal dose equivalent, and excess lifetime cancer, revealed that the highest values were observed in the mining area and downstream, specifically in the vicinity of the ore body. These elevated values exceeded the global mean value but remained below the threshold value, suggesting that routine protection measures for Pb-Zn miners during production activities are sufficient. The correlation analysis and cluster analysis revealed strong associations between radionuclides such as 238U, 226Ra, and 232Th, indicating a common source of these radionuclides. The activity ratios of 226Ra/238U, 226Ra/232Th, and 238U/40K varied with distance, suggesting the influence of geological processes and lithological composition on their transport and accumulation. In the mining catchment areas, the variations in these activity ratios increased indicated the impact of limestone material dilution on the levels of 232Th, 40K, and 238U in the upstream region. Moreover, the presence of sulfide minerals in the mining soils contributed to the enrichment of 226Ra and the removal of 238U caused those activity ratios decreased in the mining areas. Therefore, in the Jinding PbZn deposit, the patterns of mining activities and surface runoff processes in the catchment area favored the accumulation of 232Th and 226Ra over 40K and 238U. This study provides the first case study on the geochemical distributions of natural radionuclides in a typical Mississippi Valley-type PbZn mining area and offers fundamental information on radionuclide migration and baseline radiometric data for PbZn deposits worldwide.

The effectiveness of cognitive behavioural therapy for individuals with an intellectual disability and anxiety: a systematic review

INTRODUCTION

Individuals with intellectual disability (ID) are at higher risk of experiencing difficulties with anxiety than the general population. However, there are major barriers for individuals to receive appropriate services. There is a growing understanding of the importance of developing appropriate psychological interventions for this group. The objective of the current review was to systematically evaluate the findings of studies investigating the effectiveness of cognitive behavioural therapy (CBT) for individuals with ID and anxiety. Another aim was to explore which adaptions to CBT and treatment components were currently being utilised within the field.

METHOD

The electronic databases of CINAHL, EMBASE, Medline, PsycINFO, Psychology and Behavioural Sciences Collection and Scopus were searched to identify relevant studies. The methodological quality of these studies was assessed using established quality assessment tools by the National Institutes of Health for pre and post studies and case series.

RESULTS

Nine studies were included in this systematic review, all of which reported improvements in anxiety severity for some participants (25%-100%; N = 60) following CBT. Only three studies reported moderate effect sizes for CBT interventions on anxiety for individuals with ID.

DISCUSSION AND CONCLUSIONS

There is emerging literature supporting the effectiveness of CBT for individuals with mild ID. Findings highlight that CBT for individuals with anxiety and mild ID, including cognitive components, may be feasible and tolerable. While the field is gradually receiving more attention, there are significant methodological flaws present, which limit the conclusions that can be drawn regarding the effectiveness of CBT for individuals with ID. However, there is emerging evidence for techniques such as cognitive restructuring and thought replacement and modifications such as visual aids, modelling and smaller groups based on this review. Future research is warranted to investigate whether individuals with more severe ID can benefit from CBT, as well as further exploring what are the necessary components and modifications.

A machine learning model for predicting the three-year survival status of patients with hypopharyngeal squamous cell carcinoma using multiple parameters

OBJECTIVE

This study aimed to establish a model for predicting the three-year survival status of patients with hypopharyngeal squamous cell carcinoma using artificial intelligence algorithms.

METHOD

Data from 295 patients with hypopharyngeal squamous cell carcinoma were analysed retrospectively. Training sets comprised 70 per cent of the data and test sets the remaining 30 per cent. A total of 22 clinical parameters were included as training features. In total, 12 different types of machine learning algorithms were used for model construction. Accuracy, sensitivity, specificity, area under the receiver operating characteristic curve and Cohen's kappa co-efficient were used to evaluate model performance.

RESULTS

The XGBoost algorithm achieved the best model performance. Accuracy, sensitivity, specificity, area under the receiver operating characteristic curve and kappa value of the model were 80.9 per cent, 92.6 per cent, 62.9 per cent, 77.7 per cent and 58.1 per cent, respectively.

CONCLUSION

This study successfully identified a machine learning model for predicting three-year survival status for patients with hypopharyngeal squamous cell carcinoma that can offer a new prognostic evaluation method for the clinical treatment of these patients.

Fresh Groundwater Discharge as a Major Source of 90Sr into the Coastal Ocean

The behavior and source of 90Sr in the coastal ocean remain uncertain. Here, we investigated the distributions of 90Sr in coastal fresh groundwater, river water, pore water, and seawater in three bays along the southeastern coast of China between 2019 and 2021 and evaluated the potential of submarine groundwater discharge (SGD) as a source of coastal 90Sr. The 90Sr activity in coastal fresh groundwater was higher than that in river water and seawater, while the 90Sr activity in pore water was comparable to that in adjacent seawater. In addition, nonconservative mixing behavior of 90Sr along the salinity gradient between river water and seawater was observed. These observations indicated that fresh SGD may serve as an additional source of 90Sr in coastal seawater. Combining our groundwater 90Sr data with the reported fresh SGD flux data, the estimated fresh SGD-derived 90Sr fluxes into the three bays were comparable to or even higher than those supplied by riverine sources. These results revealed that fresh SGD is a major but overlooked source of 90Sr in the coastal ocean. This subterranean pathway for transport of 90Sr to the coastal ocean should be considered in the monitoring and risk assessment of coastal areas, especially those near nuclear facilities.

Trends and seasonal variation of antibiotic consumption by community residents in Hefei, China, 2012-2016

OBJECTIVES

The aim of this study was to evaluate the trends and seasonal variations of antibiotic consumption by community residents in Hefei, China, over a 5-year period.

STUDY DESIGN

This was an ecological study.

METHODS

Data on antibiotic consumption by community residents in Hefei between 2012 and 2016 were collected from the Hefei Center for Disease Control and Prevention. Statistical analysis was carried out using Microsoft Excel 2021, SPSS 26.0 and R4.1.3. An interrupted time series (ITS) analysis was modelled to assess the impact of policies on antibiotic consumption trends.

RESULTS

Amoxicillin and cephalosporins accounted for 63.64% and 30.48%, respectively, of the total defined daily dose per 1000 inhabitant-days (DID) of antibiotics in 2016. The total consumption of antibiotics decreased from 6.92 DID in 2012 to 5.61 DID in 2016 (P_trend = 0.017). Seasonal analysis showed an average of 34.24% antibiotic consumption in the winter over the 5 years. The equation constructed by the ITS analysis was Y = 5.530 + 0.323X1 - 7.574X2 - 0.323X3 + ε.

CONCLUSION

Between 2012 and 2016, overall antibiotic consumption by community residents in Hefei decreased significantly. The impact of antibiotic policies, implemented between 2011 and 2013, started to appear in 2014 when the consumption of antibiotics decreased. This study has important policy implications for the use of antibiotics at the community level. Further studies on the trends of antibiotic consumption are required, and strategies should be designed to promote appropriate use of antibiotics.

Study of Ra desorption processes in an estuary system with high-turbidity at the Southeast China

Radium (Ra) isotopes are extensively used as geochemical tracers for studying water mass mixing and submarine groundwater discharge in marginal and coastal seas. However, river-borne particles and seafloor sediments are an important source of Ra in marine systems due to Ra desorption. Therefore, it is necessary to study the desorption behaviors of Ra isotopes in river sediment or suspended particles. Here, the desorption behaviors of four Ra isotopes (²²³Ra, ²²⁴Ra, ²²⁶Ra, and ²²⁸Ra) in the Zhangjiang River sediments were investigated by a series of designed variable-controlling experiments in the laboratory. Within the designed salinity range, desorption amounts of Ra isotopes increased with increasing salinity, and when the salinity was greater than 15 ppt, Ra desorption reached an equilibrium state. Overall, desorption of Ra isotopes increased with the decrease of particle grain size, however, the desorption fractions of ²²⁴Ra and ²²⁸Ra decreased with decreasing particle size due to the increase of original Ra activities in smaller sediment particles. In the experiments, we found that two sediment samples with similar mean grain size (3.8 μm and 3.3 μm) and similar grain size distributions had significantly different Ra desorption under the same conditions. The results of mineral composition analysis based on X-ray diffraction showed that these two samples had different percentages of kaolinite, quartz, and plagioclase, which indicated that the mineral composition of particles had an important effect on Ra isotope desorption. In conclusion, salinity, particle grain size, and mineral composition all had significant effects on Ra desorption behaviors of sediment particles. Based on the above desorption experiments, the desorbed fluxes of four Ra isotopes from river-borne sediments to the Dongshan Bay were estimated to be (5.95 ± 1.47) × 10⁷ Bq yr^-1 for ²²³Ra, (1.95 ± 0.27) × 10⁹ Bq yr^-1 for ²²⁴Ra, (2.73 ± 0.47) × 10⁸ Bq yr^-1 for ²²⁶Ra, and (1.26 ± 0.20) × 10⁹ Bq yr^-1 for ²²⁸Ra, respectively.

Trace elements accumulation over a century in sediment cores from a tectonic lake on the Qinghai-Tibet plateau: Source identification and risk assessment

A record of trace elements in lake sediment can help in assessing the impact of anthropogenic activities on aquatic environments. In the present work, the trace elements profiles (Cu, Cr, Pb, Zn, As, and Cd) were determined in four sediment cores (QH01, QH02, QH07, and Z04) collected in 2012 and 2014 from Lake Qinghai to reconstruct the history of anthropogenic activity in the watershed and to evaluate the pollution status and eco-environmental risks of a typical Third Pole lake environment over the past century. The concentrations of Cu, Cr, Pb, Zn, As, and Cd in these studies ranged between 19.4 and 34.2 μg g^-1, 35.6-53.6 μg g^-1, 3.10-26.8 μg g^-1, 56.4-93.5 μg g^-1, 6.20-15.3 μg g^-1, and 0.086-0.572 μg g^-1, respectively. Statistical analyses indicated that the Pb, Zn, and Cd contents combination of coal, gasoline burning, and agricultural activities in the Lake Qinghai catchment and larger-scale atmospheric inputs during the past 60 years. The enrichment factors for Pb, Zn, and Cd in the sediments of Lake Qinghai are considered to be related to the region of the Qinghai-Tibet Plateau and national socioeconomic development. Enrich factor of Cd values was higher than 3.5 and maximum values of the geo-accumulation index of Pb and Cd were observed in the top layer of the sediment (0-2 cm), indicating moderate contamination. The RI values suggest that the risks to the ecological environment of Lake Qinghai are increasing since the 1950s. The results of this study illustrate that Lake Qinghai is still experiencing high trace elements pollution pressure due to the rapid environmental changes caused by anthropogenic activities on the remote and isolated Qinghai-Tibet Plateau.

[Clinical characteristics and prognosis in papillary thyroid carcinoma patients with recurrent laryngeal nerve invasion]

Objective: To investigate the clinical characteristics and risk factors of postoperative recurrence in papillary thyroid carcinoma (PTC) patients with recurrent laryngeal nerve (RLN) invasion. Methods: The data of PTC patients with recurrent laryngeal nerve invasion treated in Beijing Tongren Hospital, Capital Medical University from January 2006 to December 2019 were retrospectively analyzed. The acoustic parameters were compared between different subgroups. Kaplan-Meier method was used to calculate the overall survival (OS) and the recurrence-free rate (RFS), and univariate and multivariate Cox regression analyses were performed to determine the risk factors for postoperative recurrence. Results: A total of 150 PTC patients were enrolled in the final analysis, including 102 females and 48 males, with an average age of (53.5±13.7) years, and 62 patients (41.3%) aged over 55 years. There were 88 cases with stage Ⅰ, and 62 cases with stage Ⅲ. Fifty-five patients presented with preoperative vocal cord paralysis. There were 75 cases appearing adhesion between tumor or lymph node and recurrent laryngeal nerve while 75 cases presented with direct invasion. The comparisons of acoustic parameters showed that patients with RLN invasion had higher jitter compared with patients without RLN invasion [2.3% (1.4%, 3.2%) vs 1.8% (0.8%, 2.6%), P<0.001]. Moreover, patients with preoperative vocal cord paralysis (VCP) had higher jitter[3.1% (2.2%, 4.6%) vs 2.0% (1.1%, 2.8%), P<0.001] and shimmer [7.1% (4.9%, 9.9%) vs 5.5% (4.2%, 7.3%), P<0.001] and shorter maximum phonation time (MPT) [8.0 (6.0, 10.0) s vs 12.0 (10.0, 15.3) s, P<0.001] compared with patients without preoperative VCP. However, there was no statistical difference in acoustic parameters between cases with RLN adhesion and RLN invasion (all P>0.05). Postoperative follow-up time ranged between 12-196 months, with an average of (65.0±35.9) months. Sixteen patients (10.7%) had recurrence or metastasis, and 8 cases (5.3%) died of recurrence or metastasis. The 5-year OS rate was 95.1%, and the 10-year OS rate was 92.8%. The 5-year RFS rate was 88.9%, and the 10-year RFS rate was 86.2%. Univariate Cox analysis showed that age of onset ≥ 55 years, preoperative recurrent laryngeal nerve palsy, laryngeal, trachea or esophageal invasion were the risk factors for postoperative recurrence of PTC with RLN invasion (all P<0.05). Multivariate Cox analysis showed that age of onset ≥ 55 years (OR=1.060, 95%CI: 1.011-1.110, P=0.015) was an independent risk factor. Conclusions: Age of onset ≥ 55 years is an independent risk factor for postoperative recurrence in PTC patients with RLN invasion. Preoperative acoustic parameters may provide reference for evaluation of RLN function.

Quantum-inspired multicore optical fiber

We introduce a new, to the best of our knowledge, type of multicore optical fiber having a quantum-inspired network topology and unique spectral features. Particularly, the connectivity between the cores is generated by unfolding a circular array of coupled quantum oscillators in Fock space. We show that in such a fiber geometry, the eigenvalues of the optical supermodes exhibit partial degeneracy and form a ladder. In turn, this leads to revival dynamics, allowing for a periodic re-imaging of the input intensity. As an example, we present a realistic design with six cores in silica glass platforms.

The Effects of Dual-Task Training on Cognitive and Physical Functions in Older Adults with Cognitive Impairment; A Systematic Review and Meta-Analysis

BACKGROUND AND OBJECTIVE

Individuals with Alzheimer disease and dementia experience cognitive decline and reduction in physical capabilities. Engaging in cognitive challenges and physical exercises is effective in reducing age-related cognitive and physical decline. It is believed that physical activity in the context of cognitive challenges might enhance the process of neurogenesis in the adult brain, but how effective are such interventions? Is there enough evidence to support that dual-task training is more effective than cognitive or physical training alone? To what extent can such training improve cognitive and physical functions in patients at various stages of cognitive decline?

METHODOLOGY

This systematic review with meta-analysis summarizes the emerging evidence of dual-task training for enhancing cognitive and physical functions in older individuals with cognitive impairment, dementia or Alzheimer's disease. A systematic search was carried out in MEDLINE, PubMed, EMBASE, and Cochrane Library with the following search terms: randomized control trials, dual-task training, SCD, MCI, dementia, and Alzheimer's disease.

RESULTS

A total of 21 studies with 2,221 participants were identified. The results of dual-task tanning intervention are summarized as change in global cognitive function; SMD = 0.24, (P= 0.002), memory; SMD = 0.28, (P = 0.000), executive function; SMD = 0.35, (P = 0.000), attention; SMD = -0.19, (P = 0.1), gait speed; SMD = 0.26, (P = 0.007), dual-task cost; SMD 0.56, (P = 0.000), and balance; SMD 0.36, (P = 0.004).

CONCLUSION

Primary analysis showed a small-to-medium positive effect of dual-task training interventions on cognitive functions and medium-to-large positive effect on gait functions and balance.

[Effects of mesenchymal stem cells on primary culture and secretion function of parathyroid cells in vitro]

Objective: To investigate the effects of adipose-derived mesenchymal stem cells (ADMSCs) on proliferation and hormone secretion of parathyroid cells in votro. Methods: The parathyroid cells and ADMSCs were obtained from 10 SD rats by cell separation and culture. The phenotype of P3 generation for ADMSCs was detected by flow cytometry. The co-culture of parathyroid cells and ADMSCs was conducted in the ratios of 2∶1, 1∶1, 1∶2 and 1∶5, respectively. The level of parathyroid hormone in cell supernatant was determined. The results were compared with the parathyroid hormone in the supernatant of parathyroid cells cultured separately in the corresponding number. The effects of ADMSCs on the hormone secretion of parathyroid cells were evaluated. SPSS 11.0 software was used for statistical analysis. Results: The primary culture of either parathyroid cells or ADMSCs and the co-culture of these cells in vitro were performed successfully, and the in vitro culture of different proportions of the two cells showed different effects on parathyroid hormone secretion. The co-culture of parathyroid cells and ADMSCs, especially in the ratio of 1∶5, facilitated the secretion of parathyroid hormone ((1.3±0.0) vs. (0.8±0.1), (1.3±0.0) vs. (0.9±0.0), (1.7±0.5) vs. (0.9±0.0), (1.7±0.0) vs. (1.2±0.2))ng/L with t value of 25.46, 64.30, 3.32, 7.16, P<0.05 on the 2nd, 4th, 6th and 8th days respectively. Secondly, when the ratio was 1∶2, the PTH level showed an upward trend. Conclusion: Parathyroid cells and ADMSCs can be co-cultured in vitro, facilitating the secretion of parathyroid hormone under the appropriate cell proportion such as the ratio of by parathyroid cells to ADMSCs at 1∶5.

[A new classification of maxillary defect and simultaneous accurate reconstruction]

Objective: To select the preferred flaps for the reconstruction of different maxillary defects and to propose a new classification of maxillary defects. Methods: A total of 219 patients (136 males and 83 females) underwent the simultaneous reconstruction of maxillary defects in the Beijing Tongren Hospital, Capital Medical University, between January 2005 and December 2018 were reviewed. Age ranged from 16 to 78 years. Based on the proposed new classification of the maxillary defects, 22 patients with class Ⅰ defects (inferior maxillectomy), 44 patients with class Ⅱ defects (supperior maxillectomy), 132 patients with class Ⅲ defects (total maxillectomy) and 21 patients with class Ⅳ defects (extensive maxillectomy) were enrolled. Survival rate, functional and aesthetic outcomes of flaps were evaluated. Survival analysis was performed in 169 patients with malignant tumor, Kaplan-Meier method was used to calculate the survival rate, and Log-rank method was used to compare the difference of survival rate in each group. Results: A total of 234 repairs for maxillary defects were performed in 219 patients. Fibula flaps were used in 4/13 of class Ⅰ defects; temporal muscle flaps (11/24, 45.8%) and anterolateral thigh flaps (6/24, 25.0%) used in class Ⅱ defects; temporal muscle flaps (71/128, 55.5%), anterolateral thigh flaps (6/24, 25.0%) and fibula flaps (12/128, 9.4%) used in class Ⅲ defects; and anterolateral thigh flaps (8/20, 40.0%) and rectus abdominis flaps (8/20, 40.0%) used in class Ⅳ defects. The success rate of local pedicled flaps was 95.6% (109/114) and that of free flaps was 95.8% (115/120). Thrombosis(10/234,4.3%) was a main reason for repair failure. Among the followed-up 88 patients, swallowing and speech functions recovered, 82 (93.2%) of them were satisfied with appearance, and 75 (85.2%) were satisfied with visual field. The 3-year and 5-year overall survival rates were 66.5% and 63.6%, and the 3-year and 5-year disease-free survival rates were 57.1% and 46.2%, respectively, in the 169 patients with malignant tumors. Conclusion: A new classification of maxillary defects is proposed, on which suitable flaps are selected to offer patients good functional and aesthetic outcomes and high quality of life.

Monitoring Methods of Marine Pollution Range Based on Big Data Technology

With the development of big data technology, traditional monitoring methods for the scope of marine pollution can no longer meet the current needs of accuracy and timeliness. In light of the outstanding topic, this study proposed to use big data technology to monitor the scope of marine pollution. The intelligent digital remote sensing technology was used for multi-dimensional monitoring of ocean water quality and completed the calculation of data collected by water quality sensors through the improved big data comparative analysis method. Finally, the scope of pollution monitoring was realized. The results verified that the proposed monitoring method could achieve high-precision and time-sensitive monitoring of the range of marine pollutants, and could identify the basic information of pollutants.

Belantamab mafodotin for the treatment of multiple myeloma

Multiple myeloma is the second most common hematologic malignancy worldwide. Despite the growing number of available therapeutic options and advances in the treatment since the 2000s, relapse of multiple myeloma is inevitable. Currently, the main therapeutic agents for multiple myeloma treatment include proteasome inhibitors, immunomodulatory drugs, monoclonal antibodies and others. Patients who relapse or are refractory to the above-mentioned treatments have poor prognosis. B-cell maturation antigen (BCMA) is a cell-surface receptor which is expressed on the membrane of multiple myeloma cells, but absent on naive and memory B cells, making it an ideal target for multiple myeloma treatment. Belantamab mafodotin (GSK-2857916) is a first-in-class BCMA antibody-drug conjugate with an overall response rate of 32% in the phase II clinical trial DREAMM-2, which is a phase II study designed to investigate the efficacy and safety of belantamab mafodotin in relapsed/refractory patients with multiple myeloma. In August 2020, based on the results of this pivotal DREAMM-2 study, the U.S. Food and Drug Administration (FDA) approved belantamab mafodotin as a monotherapy for relapsed/refractory multiple myeloma. Thereafter, the European Medicines Agency (EMA) also approved this indication. Although belantamab mafodotin has demonstrated single-agent activity in relapsed/refractory multiple myeloma, further studies to evaluate its efficacy and its combinational use with other drugs are necessary and ongoing.

Radionuclide and trace metal accumulation in a variety of mosses used as bioindicators for atmospheric deposition

Mosses can be used as biological monitors to study metal pollution and the depositional fluxes of radionuclides. In this study, we analysed the concentrations of radionuclides (²¹⁰Pb (²¹⁰Pb_ex), ⁷Be, ¹³⁷Cs, ⁴⁰K, ²³⁸U, ²²⁶Ra, ²²⁸Ra and ²²⁸Th) and metals (Fe, Zn, Cu, Al, Pb, Cd, Cr, Ni, V and Mn) in moss and soil samples from two different regions. The metal concentrations were higher in mainland China than in the Arctic region, and this is likely associated with the comparatively lower rates of industrial production and human activity in the Arctic region. Principal component analysis and correlation results revealed two radionuclides sources types in mosses, i.e., soil (⁴⁰K, ²³⁸U, ²²⁶Ra, ²²⁸Ra and ²²⁸Ra) and atmospheric (²¹⁰Pb (²¹⁰Pb_ex), ⁷Be ¹³⁷Cs). Clustering and correlation analyses showed that different sources such as traffic (suspended dust), fossil fuels, dry and wet deposition (atmosphere and rainfall), and soil contributed to metal accumulation in mosses. The correlation between radionuclides and metals supported these observations, confirmed the accuracy of our results, and suggests that radionuclides are useful for identifying the source of metals in moss samples. The concentration ratios (CR) values of the radionuclides and the bioaccumulation factor (BCF) and enrichment factor (EF) values of metals in mosses helped identify the most environmentally sensitive moss, i.e., BS (Bryum paradoxum), which can be used for screening and monitoring radionuclides and metal pollution in urban atmospheres. These results support the use of analysing radionuclides in mosses to identify metal sources, and the potential use of mosses can to determine the atmospheric deposition fluxes of radionuclides.

[Clinical comparative study of free posterior tibial artery perforator flap and radial forearm free flap for head and neck reconstruction]

Objective: To compare the clinical application results of the FPTF (free posterior tibial artery perforator flap) and RFFF (radial forearm free flap) for reconstruction of head and neck defects. Methods: A retrospective analysis of 27 cases treated with FPTF (19 males and 8 females, aged 14-69 years) and 24 cases with RFFF (11 males and 13 females, aged 22-69 years) for head and neck defect reconstruction at Beijing Tongren Hospital of Capital Medical University from January 2015 to December 2020 was conducted. Flap size, vascular pedicle length, matching degree of recipient area blood vessels, preparation time, total operation time, hospital stay, recipient area complications, donor area complications and scale-based patient satisfaction were compared between two groups of patients with FTPF and RFFF. SPSS 26.0 statistical software was used for statistical analysis. Results: There was no statistically significant difference between the two groups of patients in tumor T staging (P=0.38), primary sites (P=0.05) and mean flap areas ((53.67±29.84) cm² vs. (41.13±11.08) cm², t=-1.472, P=0.14). However the mean vascular pedicle length of FPTF was more than that of RFFF ((11.15±2.48)cm vs. (8.50±1.69)cm, t=-4.071, P<0.01). The donor sites of 4 patients in FPTF group could be sutured directly, while all the 24 patients in RFFF group received skin grafts from the donor sites. There was no statistically significant difference in the recipient area arteries between two groups of flaps (P=0.10), with more commonly using of the facial artery (RFFF: FPTF=21∶27), but there was significant difference in the recipient area veins (P<0.01), with more commonly using of the external jugular vein in RFFF (14/24) than FPTF (4/32) and the posterior facial vein in FPTF (27/32) than RFFF (9/24). There were 10 recipient complications and 3 donor complications in RFFF group; no recipient complication and 3 donor complications occurred in FPTF group. With patient's subjective evaluation of the donor site at 12 months after surgery, FPTF was better than RFFF (χ²=22.241, P<0.01). Conclusions: FPTF is an alternative to RFFF in head and neck reconstruction and has unique advantages in aesthetics and clinical application.

Anti-biofilm potential of kefir-derived Lactobacillus paracasei L10 against Vibrio parahaemolyticus

Vibrio parahaemolyticus, a kind of biofilm-forming foodborne bacterium, presents formidable challenges to the effectiveness of antimicrobial agents. Increasingly, the safety of chemical antimicrobials has aroused the widespread attention of the public. The development of the novel nature antimicrobial agents has become critical for controlling biofilm-related pollution and infections. In this paper, we investigated the antibacterial activity of Lactobacillus paracasei L10, and evaluated the inhibition and eradication effects of the cell-free supernatant (CFS) of the strain on V. parahaemolyticus biofilms in detail. We found that the CFS exhibited marked antibacterial activity against all tested pathogenic bacteria. In co-cultural assay, L. paracasei L10 could notably reduce cell viability in both plankton and biofilm of V. parahaemolyticus and this antagonism effect in biofilm was greater than that in planktonic state. Meanwhile, the growth of V. parahaemolyticus was completely inhibited when 6% (v/v) of the CFS was added, and the supernatant also showed a concentration-dependent manner to inhibit and eradicate the biofilms of V. parahaemolyticus while decreased the metabolic activity of the biofilm in the same way. Moreover, the fluorescence microscopic and confocal laser scanning microscopy images confirmed the anti-biofilm activity of the CFS. This study elucidates that L. paracasei L10 displays a significant anti-biofilm effect on V. parahaemolyticus and the mechanism of its antagonism merits further study, which provides theoretical support for further development and application of L. paracasei L10 as anti-biofilm agents.

[Retrospective study of thyroid invasion and central lymph node metastasis in 124 patients with hypopharyngeal carcinoma]

Objective: To investigate the characteristics of thyroid invasion and central lymph node metastasis of hypopharyngeal carcinoma, and the impact on survival rate and quality of life. Methods: A retrospective analysis of 124 cases (122 males and 2 females with age range from 36 to 78 years old) with laryngopharyngeal squamous cell carcinoma who were initially treated in the Department of Head and Neck Surgery, Beijing Tongren Hospital Affiliated to Capital Medical University from January 2014 to December 2017 was performed. The clinical data included tumor location, pathological T stage, pathological N stage, invasion of thyroid gland, central lymph node metastasis, surgical procedures and so on. Patients were grouped according to if presence of thyroid invasion and central lymph node metastasis. With follow-up, the survival was analyzed by Kaplan-Meier method, and tumor recurrence and metastasis were evaluated. Results: Of the patients, 12 patients had thyroid involvement and 5 patients had central lymph node metastasis. The incidence of thyroid involvement was 8.16% (8/98) in pyriform sinus, 1/18 in posterior pharyngeal wall and 3/8 in posterior cricoid wall, with statistically significant difference (χ²=15.076,P=0.008). The incidence of central lymph node metastasis was 1.02% (1/98) in pyriform sinus, 3/18 in posterior pharyngeal wall and 1/8 in posterior cricoid wall, also with statistically significant difference (χ²=11.205, P=0.008). There was no statistical correlation between thyroid invasion or central lymph node metastasis and gender, smoking or alcohol exposure history and tumor pathological differentiation (all P>0.05). The 3-year overall survival rate was 80.65% and the 3-year recurrence free rate was 85.48%. Totally 24 patients died in 3 years, including 4 cases in thyroid invasion group and 1 case in central lymph node metastasis group. Local recurrence occurred in 18 patients, including 4 cases in thyroid invasion group and 1 case in central lymph node metastasis group. There was no significant difference in survival between patients with and without thyroid invasion and central lymph node metastasis (all P>0.05). There were significantly difference in 3-year overall survival and relapse-free survival among the groups with different T stages, N stages, pathological stages and tumor pathological differentiation levels (all P<0.05). There were significantly differences in the levels of serum calcium and FT3 between the groups with or without thyroid invasion and central lymph node metastasis (all P<0.05). Conclusion: The incidences of thyroid invasion and central lymph node metastasis of hypopharyngeal carcinoma are rare, and the risk of occurrence is related to the primary site of tumor. Comprehensive evaluation, correct decision-making and accurate treatment could be helpful to cure radically the tumor, to prevent recurrence and to improve the quality of life of patients.

Tunable stiffness enables fast and efficient swimming in fish-like robots

Fish maintain high swimming efficiencies over a wide range of speeds. A key to this achievement is their flexibility, yet even flexible robotic fish trail real fish in terms of performance. Here, we explore how fish leverage tunable flexibility by using their muscles to modulate the stiffness of their tails to achieve efficient swimming. We derived a model that explains how and why tuning stiffness affects performance. We show that to maximize efficiency, muscle tension should scale with swimming speed squared, offering a simple tuning strategy for fish-like robots. Tuning stiffness can double swimming efficiency at tuna-like frequencies and speeds (0 to 6 hertz; 0 to 2 body lengths per second). Energy savings increase with frequency, suggesting that high-frequency fish-like robots have the most to gain from tuning stiffness.

Radium desorption behavior of riverine suspended sediment: Theoretical and experimental

Radium desorption from riverine or suspended sediment is an important source term of Ra isotopes in estuarine water, which is one of the significant factors affecting the source/sink material balance for Ra applications, such as estimating submarine groundwater discharge flux in coastal zones. In this paper, a theoretical model is proposed to study Ra desorption considering several influencing factors, including salinity, particle size and size distribution, alpha recoil range of atoms in the sediment grains, and grain surface roughness. The results of the model parameter sensitivity analysis show that the alpha-decay recoil can improve the number of total exchangeable Ra on grain surfaces, but it is more significant for sediment of small grain size. Sediment with large mean grain size may contain a considerable number of smaller particles, which may facilitate the Ra desorption quantity. Due to the relatively low concentrations of Ra in natural mineral, the Ra desorption quantity is not sensitive to the roughness of the sediment grain surfaces. The model fits well with the indoor experimental data, by fitting the experimental data or quoting the literature values, the desorption parameters (A, B, α, β) in the model can be determined to estimate the total number of exchangeable Ra of a sediment and also predict the Ra desorption of sediments in different conditions.

[Application of deep convolutional neural networks in the diagnosis of laryngeal squamous cell carcinoma based on narrow band imaging endoscopy]

Objective: To explore the possibility of using artificial intelligence (AI) technology based on convolutional neural network (CNN) to assist the clinical diagnosis of laryngeal squamous cell carcinoma (LSCC) through deep learning algorithm. Methods: A deep CNN was developed and applied in narrow band imaging (NBI) endoscopy of 4 799 patients with laryngeal lesions, including 3 168 males and 1 631 females, aged from 21 to 87 years, from 2015 to 2017 in Beijing Tongren Hospital, Capital Medical University. A simple randomization method was used to select the laryngeal NBI images of 2 427 patients (1 388 benign lesions and 1 039 LSCC lesions) for the training and correction the CNN model. The remaining laryngeal NBI images of 2 372 patients (including 1 276 benign lesions and 1 096 LSCC lesions) were used as validation data set to compare performance between CNN and otolaryngologists. SPSS 21.0 software was used for Chi-square test to calculate the accuracy, sensitivity and specificity of AI and otolaryngologists. The area under the curve (AUC) of receiver operating curve (ROC) was used to evaluate the diagnostic ability of the algorithm for NBI images. Results: The accuracy, sensitivity and specificity for NBI predictions were respectively 90.91% (AUC=0.96), 90.12% and 91.53%, which were equivalent to those for otolaryngologists' predictions (accuracy, sensitivity and specificity were (91.93±3.20)%, (91.33±3.25)% and (93.02±2.59)%, t values were 0.64, 0.75 and 1.17, and P values were 0.32, 0.28 and 0.21, respectively). The diagnostic efficiency of CNN was significantly higher than that of otolaryngologists (0.01 vs. 5.50, t =9.15, P<0.001). Conclusion: AI based on deep CNN is effective for using in the laryngeal NBI image diagnosis, showing a good application prospect in the diagnosis of LSCC.

[A single-arm prospective study on induction chemotherapy and subsequent comprehensive therapy for advanced hypopharyngeal squamous cell carcinoma: report of 260 cases in a single center]

Objective: To study the significance of induction chemotherapy and subsequent comprehensive therapy for overall survival rate (OS) and larynx dysfunction-free survival rate (LDFS) in patients with advanced hypopharyngeal carcinoma. Methods: Patients who met the inclusion criteria with the diagnoses of advanced hypopharyngeal carcinoma between 2011 and 2017 received 2 or 3 cycles of TPF regimen induction chemotherapy. Patients who attained complete response (CR) received radical chemotherapy. Patients who attained partial response (PR) and the reduction of tumor volume was more than 70% were defined as large PR and received concurrent chemoradiotherapy. When the tumor volume reduction of PR patients was less than 70%, they were defined as small PR. (CR+large PR) group was defined as effective group. Patients who did not reach CR and large PR were defined as uneffective group and underwent radical surgery and received adjuvant radiotherapy as appropriate after the surgery. The end points of the study were OS, progression-free survival (PFS) and LDFS. Chi-square (χ(2)) test was used for correlation analysis. Survival analysis was performed by the Kaplan-Meier method with a Log-rank test. Cox proportional hazards model was used for univariate and multivariate survival analysis. Results: A total of 260 patients were enrolled in the study. The follow-up period ranged from 5 to 83 months, with an average of 24.7 months. The 3-year and 5-year OS rate was 46.0% and 32.6%, respectively. The 3-year and 5-year PFS rate was 41.0% and 26.6%, respectively. The 3-year and 5-year LDFS rate was 37.9% and 24.8%, respectively. Poor outcome of induction chemotherapy, advanced N stage, strong positive Ki-67 immunohistochemistry (all P<0.001) were negative prognostic factors. The advanced clinical stage was positively related to the poor outcome of induction chemotherapy (P=0.015). There was no significant difference in OS and PFS between the large PR group and the small PR group (all P>0.005). Conclusion: TPF regimen induction chemotherapy and subsequent comprehensive therapy for patients with advanced hypopharyngeal carcinoma may improve the quality of life of patients, with high OS rate and LDFS rate.

Role of miR-579-3p in the development of squamous cell lung carcinoma and the regulatory mechanisms

OBJECTIVE

The aim of this study was to explore the role of microRNA-579-3p (miR-579-3p) in the development of squamous cell lung carcinoma (SCLC). Our findings might provide new insights into the treatment of SCLC.

PATIENTS AND METHODS

Quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) was performed to examine the expression level of miR-579-3p in 30 pairs of CRC tissues and para-cancerous tissues. The relation between miR-579-3p expression and clinical features of SCLC patients was analyzed. MiR-579-3p expression in SCLC cells was further verified by qRT-PCR as well. In addition, the effects of miR-579-3p on the migration and invasion of SK-MES-1 cells were examined through the transwell assay.

RESULTS

QRT-PCR results revealed for the first time that miR-579-3p was significantly down-regulated in SCLC tissues. This indicated that miR-579-3p was possibly involved in the development of SCLC. According to bioinformatics prediction websites and the luciferase activity assay, macrophage scavenger receptor 1 (MSR1) was predicted and verified as the target gene of miR-579-3p. Transfection of miR-579-3p mimics significantly reduced the protein expression level of MSR1 in cells, eventually inhibiting the proliferation, invasion, and migration of SCLC cells.

CONCLUSIONS

The miR-579-3p/MSR1 axis might be a novel regulatory pathway of apoptosis, which could be used as potential therapeutic sites in SCLC.