Study on the Antifungal Activity of Gallic Acid and Its Azole Derivatives against Fusarium graminearum

The wheat scab caused by Fusarium graminearum (F. graminearum) has seriously affected the yield and quality of wheat in China. In this study, gallic acid (GA), a natural polyphenol, was used to synthesize three azole-modified gallic acid derivatives (AGAs1-3). The antifungal activity of GA and its derivatives against F. graminearum was studied through mycelial growth rate experiments and field efficacy experiments. The results of the mycelial growth rate test showed that the EC50 of AGAs-2 was 0.49 mg/mL, and that of AGAs-3 was 0.42 mg/mL. The biological activity of AGAs-3 on F. graminearum is significantly better than that of GA. The results of field efficacy tests showed that AGAs-2 and AGAs-3 significantly reduced the incidence rate and disease index of wheat scab, and the control effect reached 68.86% and 72.11%, respectively. In addition, preliminary investigation was performed on the possible interaction between AGAs-3 and F. graminearum using density functional theory (DFT). These results indicate that compound AGAs-3, because of its characteristic of imidazolium salts, has potential for use as a green and environmentally friendly plant-derived antifungal agent for plant pathogenic fungi.

Evolutionary trends and analysis of the driving factors of Ulva prolifera green tides: A study based on the random forest algorithm and multisource remote sensing images

Understanding the prolonged spatiotemporal evolution and identifying the underlying causes of Ulva prolifera green tides play pivotal roles in managing such occurrences, restoring water ecology, and fostering sustainable development in marine ecosystems. Satellite remote sensing represents the primary choice for monitoring Ulva prolifera green tides due to its capability for extensive, long-term ocean monitoring. Based on multi-source remote sensing images, ecological and environmental datasets, and machine learning algorithms, therefore, this study focused on "remote sensing modelling - evolution history - change trends - mechanism analysis" to elucidate both the remote sensing monitoring models and the underlying driving factors governing the spatiotemporal evolution of Ulva prolifera green tides in the highly impacted South Yellow Sea of China. With the use of GOCI Ⅰ/Ⅱ images, an hybrid remote sensing extraction model merging the robustness of the random forest (RF) model and the optical algae cloud index (ACI) was established to map Ulva prolifera distribution patterns. The ACI-RF method exhibited exceptional performance, with an F1 score surpassing 0.95, outperforming alternative methods such as the support vector machine (SVM) and K-nearest neighbour (KNN) methods. On the basis, we analysed the evolutionary trends and the driving factors determining these distribution patterns using meteorological data, runoff data, and data on various water quality parameters (SST, ocean current speed, wind speed, precipitation, DO, PAR, Si, NO3-, PO43-and N/P). Over the period from 2011 to 2022, excluding 2021, there was a notable decline in the area of Ulva prolifera green tides, varying between 397 and 2689.9 km2, with an average annual reduction rate of 3%. The maximum annual biomass varied between 0.12 and 15.9 kt. Notably, more than 75% of the area of Ulva prolifera green tides exhibited northward drift, which was significantly influenced by northern currents and wind fields. The analysis of driving factors indicates that factors such as average sea surface temperature, eastward wind speed, northward wind speed, precipitation, PO43- and N/P/Si significantly influence the biological growth rate of Ulva prolifera. Furthermore, coastal land use change and surface runoff, particularly surface runoff in June, significantly impacted the growth rate of Ulva prolifera, with Pearson correlation coefficients of 0.74 and 0.67, respectively. Against the background of global warming and severe deterioration in the marine environment, Ulva prolifera blooms persist. Consequently, two distinct management strategies were proposed based on the distribution patterns and cause analysis results for addressing Ulva prolifera green tides: establishing a continuous protection framework for rivers, lakes, and nearshore areas to mitigate pollutant inputs and implementing precise environmental monitoring measures in urban expansion areas and farmlands to combat overgrowth-induced green tides. This methodology could be applied in other regions affected by marine ecological disasters, and the criteria for selecting influencing factors offer a valuable reference for designing tailored and proactive measures aimed at controlling Ulva prolifera green tides.

Observation of Seven Astrophysical Tau Neutrino Candidates with IceCube

We report on a measurement of astrophysical tau neutrinos with 9.7 yr of IceCube data. Using convolutional neural networks trained on images derived from simulated events, seven candidate ν_{τ} events were found with visible energies ranging from roughly 20 TeV to 1 PeV and a median expected parent ν_{τ} energy of about 200 TeV. Considering backgrounds from astrophysical and atmospheric neutrinos, and muons from π^{±}/K^{±} decays in atmospheric air showers, we obtain a total estimated background of about 0.5 events, dominated by non-ν_{τ} astrophysical neutrinos. Thus, we rule out the absence of astrophysical ν_{τ} at the 5σ level. The measured astrophysical ν_{τ} flux is consistent with expectations based on previously published IceCube astrophysical neutrino flux measurements and neutrino oscillations.

Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the empa-kidney trial

BACKGROUND

Sodium-glucose co-transporter-2 (SGLT2) inhibitors reduce progression of chronic kidney disease and the risk of cardiovascular morbidity and mortality in a wide range of patients. However, their effects on kidney disease progression in some patients with chronic kidney disease are unclear because few clinical kidney outcomes occurred among such patients in the completed trials. In particular, some guidelines stratify their level of recommendation about who should be treated with SGLT2 inhibitors based on diabetes status and albuminuria. We aimed to assess the effects of empagliflozin on progression of chronic kidney disease both overall and among specific types of participants in the EMPA-KIDNEY trial.

METHODS

EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA), and included individuals aged 18 years or older with an estimated glomerular filtration rate (eGFR) of 20 to less than 45 mL/min per 1·73 m2, or with an eGFR of 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher. We explored the effects of 10 mg oral empagliflozin once daily versus placebo on the annualised rate of change in estimated glomerular filtration rate (eGFR slope), a tertiary outcome. We studied the acute slope (from randomisation to 2 months) and chronic slope (from 2 months onwards) separately, using shared parameter models to estimate the latter. Analyses were done in all randomly assigned participants by intention to treat. EMPA-KIDNEY is registered at ClinicalTrials.gov, NCT03594110.

FINDINGS

Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and then followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroups of eGFR included 2282 (34·5%) participants with an eGFR of less than 30 mL/min per 1·73 m2, 2928 (44·3%) with an eGFR of 30 to less than 45 mL/min per 1·73 m2, and 1399 (21·2%) with an eGFR 45 mL/min per 1·73 m2 or higher. Prespecified subgroups of uACR included 1328 (20·1%) with a uACR of less than 30 mg/g, 1864 (28·2%) with a uACR of 30 to 300 mg/g, and 3417 (51·7%) with a uACR of more than 300 mg/g. Overall, allocation to empagliflozin caused an acute 2·12 mL/min per 1·73 m2 (95% CI 1·83-2·41) reduction in eGFR, equivalent to a 6% (5-6) dip in the first 2 months. After this, it halved the chronic slope from -2·75 to -1·37 mL/min per 1·73 m2 per year (relative difference 50%, 95% CI 42-58). The absolute and relative benefits of empagliflozin on the magnitude of the chronic slope varied significantly depending on diabetes status and baseline levels of eGFR and uACR. In particular, the absolute difference in chronic slopes was lower in patients with lower baseline uACR, but because this group progressed more slowly than those with higher uACR, this translated to a larger relative difference in chronic slopes in this group (86% [36-136] reduction in the chronic slope among those with baseline uACR <30 mg/g compared with a 29% [19-38] reduction for those with baseline uACR ≥2000 mg/g; ptrend<0·0001).

INTERPRETATION

Empagliflozin slowed the rate of progression of chronic kidney disease among all types of participant in the EMPA-KIDNEY trial, including those with little albuminuria. Albuminuria alone should not be used to determine whether to treat with an SGLT2 inhibitor.

FUNDING

Boehringer Ingelheim and Eli Lilly.

Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial

BACKGROUND

The EMPA-KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population.

METHODS

EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110.

FINDINGS

Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62-0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16-1·59), representing a 50% (42-58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1).

INTERPRETATION

In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease.

FUNDING

Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council.

Oxidized of chitosan with different molecular weights for potential antifungal and plant growth regulator applications

The application of Chitosan (CS) in drug delivery systems, plant growth promotion, antibacterial potentiality and plant defense is significantly limited by its inability to dissolve in neutral solutions. In this work, CS with different molecular weights (Mw) has been oxidized, yielding five kinds of oxidized chitosan (OCS 1-5) with solubilities in neutral solutions. The results obtained from Fourier Transform Infrared Spectroscopy clearly showed the successful oxidation of the hydroxyl group to form aldehyde and carboxyl groups. And the CS derivatives showed the wrinkled and lamellar structures on the surface of OCS. The results of antifungal activity against Fusarium graminearum showed that the OCS dissolved in 2 % (V/V) acetic acid exhibited better performance of almost complete inhibition of mycelial growth compared with CS at the concentration of 500 μg/mL. Among the five OCS, OCS-4 exhibited the best antifungal effect and had the lowest EC50 value of 581.68 μg/mL in samples. OCS-4 displayed superior promoting effect on seed germination with a germination potential of 62.2 % at a concentration of 3 g/L and a germination rate of 74.5 %. Additionally, the other four OCS also showed excellent antifungal activity with dose-dependent manners. These results indicated that the OCS had excellent antifungal potential in agricultural production.

Intraoral Gavage of Second-Generation Probiotic Lactobacillus Reuteri Releasing IFN-β (LR-IFN-β) Mitigates Intestinal Irradiation Toxicity and Improves Survival During Whole Abdomen Irradiation (WAI)

PURPOSE/OBJECTIVE(S)

We sought to establish a method by which to overcome the toxicity of WAI to facilitate clinical application in Ovarian Cancer patients.

MATERIALS/METHODS

We irradiated C57BL/6J mice to 19.75 Gy WAI and assessed the primary endpoint of overall survival (OS). In a separate experiment, mice were irradiated to 12 Gy WAI and intestinal barrier integrity was compared between groups: control (0 Gy), irradiation only, 12 Gy + LR, 12 Gy + IFN-β, and 12 Gy + LR-IFN-β. Luminex assay of plasma and intestinal cells were also assayed at day 5 after WAI for radiation-induced inflammatory cytokines, and fecal matter was analyzed for LR-IFN-β clearance and levels of the LR-derived IFN-β gene from day 1 to 5 in control non-irradiated mice. Moreover, fluorescent beads were intraorally administered three hours prior to sacrifice at days 2 or 5 after WAI, and blood was assayed for beads.

RESULTS

Mice receiving LR-IFN-β (109 bacteria in 100 mL of saline) 24-hours following a single fraction of 19.75 Gy WAI showed improved OS compared to control irradiated mice (p = 0.03). LR-IFN-β gavage maintained intestinal barrier integrity (p < 0.05) by stimulating intestinal stem cells regenerations (improved levels of Lgr5+ cells, occludin, and I-CAM; p < 0.05), and reduced levels of intestinal pro-inflammatory cytokines, including IFN-γ (p = 0.0261), IL-3 (p < 0.0020) and IL-17 (p < 0.0070). There was no significant effect of control LR or intraperitoneal injection of IFN-β protein at 24 hours after WAI. Detectable levels of LR-IFN-β bacteria were also cleared from fecal matter by day three via colony assay and rt-PCR, with no detectable growth of LR-IFN-β in blood from gavaged irradiated mice (13.5 Gy WAI).

CONCLUSION

LR-IFN-β is both a feasible and effective radiation mitigator that could potentially improve the management of ovarian cancer patients. Furthermore, the subsequent addition of platinum/taxane-based chemotherapy to the combination of WAI and LR-IFN-β should reduce tumor volume while protecting the intestine and thus improve overall survival in ovarian cancer patients.

Grade 4 Lymphopenia Might Associate with Pericardial Irradiation Dose and Worse Prognosis in Patients with Locally Advanced Esophageal Cancer Receiving Concurrent Chemo-Radiotherapy

PURPOSE/OBJECTIVE(S)

The immune system may influence prognosis, and lymphopenia is a frequent side effect of concurrent chemo-radiotherapy (CCRT). Radical irradiation for locally advanced esophageal cancer (LA-EC) exposes significant vascular and heart volumes, and we hypothesized that lymphopenia is linked to cardiac and pericardial doses and affects patient prognosis.

MATERIALS/METHODS

We identified 190 LA-EC patients who received radical CCRT between 2011 and 2019. Cardiac, pericardial, and lung dosimetric parameters were obtained and multivariate analysis (MVA) was performed to correlate clinical factors and dosimetric parameters with overall survival (OS). Absolute lymphocyte count (ALC), absolute platelet count (PLT), absolute white blood cell count (WBC), absolute neutrophil count (ANC), neutrophil-lymphocyte ratio (NLR = ANC/ALC), and platelet-lymphocyte ratio (PLR = PLT/ALC) were collected before and during CRT. Grade 4 (G4) lymphopenia was defined as Lymphocyte count nadir <0.2 103/mL during CRT and it was used to dichotomize the lymphocyte count nadir. MVA was performed to correlate hematologic toxicity with OS. Logistic stepwise regression was performed to determine the relationship between dosimetric parameters and G4 lymphopenia. Finally, a nomogram of G4 lymphopenia was developed and validated externally.

RESULTS

Median follow-up time for all patients was 27.5 months (range 12-118 months). On MVA for OS (n = 190), higher pericardial V30 (PV30) was linked to worse survival (HR = 1.013, 95% CI 1.001-1.026, p = 0.039). The median OS stratified by PV30>55.3% and PV30≤55.3% was 24 months and 54 months, respectively (p = 0.004). G4 lymphopenia was shown to be linked with worse OS in the MVA of hematological toxicity (n = 161) with OS (HR = 2.042, 95% CI 1.335-3.126, p = 0.001). 24 (24%) of the 100 patients in the training set had G4 lymphopenia. Our final model comprised Stage-IVA (p = 0.017), PLR during CRT (p = 0.008), Heart V50 (p = 0.046), and PV30 (p = 0.048). External validation 26 of 90 patients (29%) had grade 4 lymphocytopenia. The ROC curve displays an AUC for internal validation of 0.775 and external validation of 0.843.

CONCLUSION

Higher doses of pericardial radiation might affect LA-EC patients' prognosis by inducing G4 lymphopenia in CCRT process. Further prospective studies are warranted to confirm these findings, especially in the era of immune-checkpoint inhibitor treatment.

Global burden of neoplasms attributable to specific occupational carcinogens over 30 years: a population-based study

OBJECTIVES

The study aimed to analyze the global burden of occupational neoplasms from various epidemiological perspectives.

STUDY DESIGN

In this cross-sectional study, secondary analyses were conducted to assess the burden of neoplasms attributable to occupational carcinogens and their distribution characteristics using data from GBD 2019 and the World Bank database.

METHODS

Based on the GBD 2019 and the World Bank database, we analyzed the global burden of occupational neoplasms including the age-period-cohort model, decomposition analysis, health inequality analysis, and panel model. All analyses were conducted in R (version 4.0.3) and Joinpoint (version 4.9.1).

RESULTS

The absolute number of neoplasms burden attributable to occupational carcinogens has continued to rise over 30 years. In 2019, occupational neoplasms caused 333,867 [95% uncertainty interval (UI): 263,491 to 404,641] mortalities and 6,964,775 (95% UI: 5,467,884 to 8,580,431) disability-adjusted life years (DALYs) globally. Greenland, Monaco, the Netherlands, and Andorra suffered the highest burden. The burden was higher in countries with a higher sociodemographic index. The age effect was prominent in the elderly, and the 1925 birth cohort had the highest cohort effect. Population growth was the most significant driver of the mortalities (89%) and DALYs (111%) change. Moreover, the proportion of urban population was significantly positively associated with the disease burden, while GDP per capita was negatively correlated with the disease burden.

CONCLUSIONS

The burden of occupational neoplasms was unevenly distributed across locations and populations. The need for rational allocation of healthcare resources was urgent.

Observation of high-energy neutrinos from the Galactic plane

The origin of high-energy cosmic rays, atomic nuclei that continuously impact Earth's atmosphere, is unknown. Because of deflection by interstellar magnetic fields, cosmic rays produced within the Milky Way arrive at Earth from random directions. However, cosmic rays interact with matter near their sources and during propagation, which produces high-energy neutrinos. We searched for neutrino emission using machine learning techniques applied to 10 years of data from the IceCube Neutrino Observatory. By comparing diffuse emission models to a background-only hypothesis, we identified neutrino emission from the Galactic plane at the 4.5σ level of significance. The signal is consistent with diffuse emission of neutrinos from the Milky Way but could also arise from a population of unresolved point sources.

Hydroxylation of some emerging disinfection byproducts (DBPs) in water environment: Halogenation induced strong pH-dependency

In this work, the hydroxylation mechanisms and kinetics of some emerging disinfection byproducts (DBPs) have been systematically investigated through theoretical calculation methods. Five chlorophenols and eleven halogenated pyridinols were chosen as the model compounds to study their pH-dependent reaction laws in UV/H₂O₂ system. For the reactions of HO^• with 37 different dissociation forms, radical adduct formation (RAF) was the main reaction pathway, and the reactivity decreased with the increase of halogenation degree. The k_app values (at 298 K) increased with the increase of pH from 0 to 10, and decreased with the increase of pH from 10 to 14. Compared with phenol, the larger the chlorination degree in chlorophenols was, the stronger the pH sensitivity of the k_app values; compared with chlorophenols, the pH sensitivity in halogenated pyridinols was further enhanced. As the pH increased from 2 to 10.5, the degradation efficiency increased at first and then decreased. With the increase of halogenation degree, the degradation efficiency range increased, the pH sensitivity increased, the optimal degradation efficiency slightly increased, and the optimal degradation pH value decreased. The ecotoxicity and bioaccumulation of most hydroxylated products were lower than their parental compounds. These findings provided meaningful insights into the strong pH-dependent hydroxylation of emerging DBPs on molecular level.

Molecular cloning, expression analysis and functional characterization of chicken cytochrome P450 27A1: A novel mitochondrial vitamin D3 25-hydroxylase

Vitamin D₃ is hydroxylated by cytochrome P450 (CYP) before exerting biological effects. The chicken CYP involved in vitamin D₃ 25-hydroxylation has yet to be cloned, and little is known about its functional characteristics, tissue distribution, and cellular expression. We identified a novel, full-length CYP27A1 gene cloned from chicken hepatocyte cDNA that encodes a putative protein of 518 amino acids. Swiss modeling revealed that chicken CYP27A1 has a classic open-fold form. Multisequence homology alignment determined that CYP27A1 contains conserved motifs for substrate recognition and binding. Quantitative real-time PCR analysis in 2-mo-old Partridge Shank broilers demonstrated that CYP27A1 mRNA levels were highest in the liver, followed by the thigh muscles, the breast muscles, and kidneys. The transcripts of CYP27A1 in breast muscles were significantly higher in males than in females. A subcellular localization analysis demonstrated that CYP27A1 was mainly expressed in the mitochondria. In vitro enzyme assays suggested that recombinant CYP27A1 hydroxylates vitamin D₃ at the C-25 position to form 25-hydroxyvitamin D₃ (25(OH)D₃). The K_m and V_max values for CYP27A1-dependent vitamin D₃ 25-hydroxylation were estimated to be 4.929 μM and 0.389 mol min^-1 mg^-1 protein, respectively. In summary, these results suggest that CYP27A1 encodes a mitochondrial CYP that plays an important physiologic role in the 25-hydroxylation of vitamin D₃ in chickens, providing novel insights into vitamin D₃ metabolism in this species.

Measuring quality of reporting in systematic reviews of diagnostic test accuracy studies in medical imaging: comparison of PRISMA-DTA and PRISMA

OBJECTIVES

To compare the reporting quality measured by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses of Diagnostic Test Accuracy studies (PRISMA-DTA) vs the original PRISMA checklist for systematic reviews of diagnostic test accuracy studies in imaging and survey the use of PRISMA-DTA by researchers and endorsement by journals.

METHODS

Systematic reviews of DTA studies published in 2020 and 2021 in Quartile 1 and Quartile 3 medical imaging journals (defined by Journal Citation Reports) were identified through PubMed. The reporting of each systematic review was assessed using PRISMA-DTA, PRISMA-2009 and PRISMA-2020. The item scores and overall score were compared among the three checklists. We also examined checklist adoption by the included systematic reviews and surveyed checklist endorsement from author instructions of included journals.

RESULTS

A total of 173 systematic reviews from 66 journals were included. The use of PRISMA-DTA, compared with PRISMA-2009 and PRISMA-2020, identified more issues in the reporting of title (proportion of systematic reviews with proper reporting, 27.2% vs 98.8% vs 98.8%), abstract (39.3% vs 97.1% vs 64.7%), eligibility criteria (67.6% vs 94.2% vs 94.2%), search (28.9% vs 72.3% vs 28.9%), definitions for data extraction (14.5% vs 91.9% vs 91.9%), diagnostic accuracy measures (38.2% vs 93.6% vs 93.6%), synthesis of results (28.9% vs 89.6% vs 73.4%) and results of individual studies (40.5% vs 80.3% vs 80.3%). The overall median reporting score measured by PRISMA-DTA (72.0% (interquartile range (IQR), 66.7-77.8%)) was lower than that measured by PRISMA-2009 (88.9% (IQR, 84.0-92.6%)) and similar to that measured by PRISMA-2020 (74.1% (IQR, 66.7-77.8%)). Additionally, PRISMA-DTA was used by only 43 (24.9%) systematic reviews and endorsed by two (3.0%) journals. These trends remained consistent for reviews published in journals with diverse scientific impact.

CONCLUSIONS

The use of PRISMA-DTA may identify more reporting inadequacies compared with the original PRISMA checklists when assessing diagnostic test accuracy systematic reviews, especially in critical sections such as title, abstract and methods. However, this tool is not commonly used by researchers and is inadequately endorsed by imaging journals. Our findings suggest a strong need to use PRISMA-DTA for reporting of diagnostic test accuracy systematic reviews by authors and its endorsement by journals. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.

[An introduction to multidisciplinary recommendations for Wilson's disease comprehensive diagnosis and management: 2022 practice guidance from the American Association for the Study of Liver Diseases]

The incidence of Wilson's disease (WD) is global, with an estimated prevalence rate of 30 per million or higher. WD clinical manifestations can be liver disease, progressive neurologic deficits (non evident or even absent liver dysfunction), psychiatric disorders, or a combination of these. Children and younger patients are more likely to develop WD as an isolated liver disease than older patients. Symptoms are often vague and can appear at any age. To that end, in 2022, the American Association for the Study of Liver Diseases published the full version of the WD guidelines and recommendations developed by a panel of experts, providing a modern approach for WD diagnosis and management in an effort to assist clinicians in implementing the most recent diagnostic and management strategies.

Search for Unstable Sterile Neutrinos with the IceCube Neutrino Observatory

We present a search for an unstable sterile neutrino by looking for a resonant signal in eight years of atmospheric ν_{μ} data collected from 2011 to 2019 at the IceCube Neutrino Observatory. Both the (stable) three-neutrino and the 3+1 sterile neutrino models are disfavored relative to the unstable sterile neutrino model, though with p values of 2.8% and 0.81%, respectively, we do not observe evidence for 3+1 neutrinos with neutrino decay. The best-fit parameters for the sterile neutrino with decay model from this study are Δm_{41}^{2}=6.7_{-2.5}^{+3.9}  eV^{2}, sin^{2}2θ_{24}=0.33_{-0.17}^{+0.20}, and g^{2}=2.5π±1.5π, where g is the decay-mediating coupling. The preferred regions of the 3+1+decay model from short-baseline oscillation searches are excluded at 90% C.L.

[Clinicopathological characteristics related to Miller/Payne grading system of breast carcinoma after neoadjuvant therapy and establishment of novel prediction models]

Objective: To investigate the correlation between clinicopathological features and Miller/Payne (MP) grading system of breast carcinoma after neoadjuvant treatment and to establish novel prediction models. Methods: A total of 1 053 cases of invasive breast carcinoma NOS that undertaken neoadjuvant treatment according to Guidelines of CSCO for Breast Cancer were selected at the Key Laboratory of Carcinogenesis and Translational Research, Peking University Cancer Hospital & Institute from September 2016 to September 2019, and the clinical, pathologic data, MP grading and immunohistochemical staining were evaluated. Statistical analysis was conducted using R software. Several novel computer models on prediction of MP grading were established and validated. Results: Among 1 053 patients who accepted neoadjuvant treatment, 316 patients (316/1 053, 30%) were evaluated as MP5 postoperatively, and 737 patients (737/1 053, 70%) did not meet MP5 level. MP5 had significant association with histological grade, ER and PR expression, HER2 status, Ki-67 index and molecular classification (P<0.05). Univariate/multivariate logistic regression analyses further showed that the above clinicopathological features were also independent influencing factors of MP5 grade; five-fold cross-validation was used to evaluate the performance of the models, and the sensitivity and specificity of different models were obtained. Conclusions: MP grading of invasive breast carcinoma NOS after neoadjuvant treatment is associated with high histological grade, negative ER and PR expression, HER2 positivity, high Ki-67 index and molecular classification, which are independent influence factors. GBM model recommended through comparison can provide some help for clinical diagnosis and treatment.

Evaluation of sulfonated oxidized chitosan antifungal activity against Fusarium graminearum

Chitosan biomaterials are widely used in the biological area because of their broad-spectrum antibacterial activity. However, chitosan cannot be dissolved in a neutral solution, limiting its application in various fields seriously. In this study, water-soluble sulfonated oxidized chitosan (SOCS) with antifungal activity were prepared by oxidization and sulfonation. Its structure was clearly confirmed by spectroscopy data (FTIR, 1H NMR, ¹³C NMR) and elemental analysis. SEM images of OCS and SOCS revealed that there was a little curly and an irregular sheet-like morphologies on them which was attributed to the oxidation and sulfonation on CS. Moreover, the FTIR and NMR indicated that -OH on the CS was oxidized into -COOH on the OCS and -SO₃H groups on the SOCS. The EDS results of OCS and SOCS confirmed the presence of the oxygen element in OCS and the S element in SOCS. All studies confirmed the OCS and SOCS were synthesized successfully. Furthermore, the inhibitory activity of SOCS biocomposites against plant pathogenic fungi, (Fusarium graminearum), was investigated. The results showed that the SOCS have significant inhibitory effects on the mycelial growth of F. graminearum. The EC₅₀ value of SOCS against F. graminearum is 79.46 μg/mL. The research results presented above indicated that SOCS can be used as a candidate material for the control of plant pathogenic fungi, and can broaden the application of chitosan materials in plant protection and sustainable agriculture.Research highlightsSOCS showed better solubility in deionized water.The antifungal effect of SOCS dissolved in acetic acid was higher than that of CS dissolved in acetic acid.SOCS dissolved in water can cause an inhibitory effect on F. graminearum at lower concentrations.

The Role of Gut Microbiota—Gut—Brain Axis in Perioperative Neurocognitive Dysfunction

With the aging of the world population and advances in medical and health technology, more and more elderly patients are undergoing anesthesia and surgery, and perioperative neurocognitive dysfunction (PND) is receiving increasing attention. The latest definition of PND, published simultaneously in November 2018 in 6 leading journals in the field of anesthesiology, clarifies that PND includes preoperatively cognitive impairment, postoperative delirium, delayed neurocognitive recovery, and postoperative cognitive dysfunction and meets the diagnostic criteria for neurocognitive impairment in the Diagnostic and Statistical Manual of Mental Disorders -fifth edition (DSM-5). The time frame for PND includes preoperatively and within 12 months postoperatively. Recent studies have shown that gut microbiota regulates central nervous function and behavior through the gut microbiota - gut - brain axis, but the role of the axis in the pathogenesis of PND remains unclear. Therefore, this article reviews the mechanism of the role of gut microbiota-gut-brain axis in PND, so as to help explore reasonable early treatment strategies.

Nanopesticide Formulation from Pyraclostrobin and Graphene Oxide as a Nanocarrier and Application in Controlling Plant Fungal Pathogens

Efficient and environment-friendly nanopesticide delivery systems are critical for the sustainable development of agriculture. In this study, a graphene oxide nanocomposite was developed for pesticide delivery and plant protection with pyraclostrobin as the model pesticide. First, graphene oxide-pyraclostrobin nanocomposite was prepared through fast adsorption of pyraclostrobin onto graphene oxide with a maximum loading of 87.04%. The as-prepared graphene oxide-pyraclostrobin nanocomposite exhibited high stability during two years of storage, suggesting its high potential in practical application. The graphene oxide-pyraclostrobin nanocomposite could achieve temperature (25 °C, 30 °C and 35 °C) and pH (5, 7 and 9) slow-release behavior, which overcomes the burst release of conventional pyraclostrobin formulation. Furthermore, graphene oxide-pyraclostrobin nanocomposite exhibited considerable antifungal activities against Fusarium graminearum and Sclerotinia sclerotiorum both in vitro and in vivo. The cotoxicity factor assay revealed that there was a synergistic interaction when graphene oxide and pyraclostrobin were combined at the ratio of 1:1 against the mycelial growth of Fusarium graminearum and Sclerotinia sclerotiorum with co-toxicity coefficient values exceeding 100 in vitro. The control efficacy of graphene oxide-pyraclostrobin nanocomposite was 71.35% and 62.32% against Fusarium graminearum and Sclerotinia sclerotiorum in greenhouse, respectively, which was higher than that of single graphene oxide and pyraclostrobin. In general, the present study provides a candidate nanoformulation for pathogenic fungal control in plants, and may also expand the application of graphene oxide materials in controlling plant fungal pathogens and sustainable agriculture.

[Interpretation of the 2022 edition guidelines for hepatolenticular degeneration diagnosis and treatment]

In order to help liver disease-related clinicians make rational decisions, the Inherited and Metabolic Liver Disease Cooperative Group of Hepatology Branch of Chinese Medical Association released the 2022 edition guidelines for hepatolenticular degeneration diagnosis and treatment. This article introduces the ten highlights of this guideline from the aspects of epidemiology, pathogenesis, clinical characteristics, laboratory tests, diagnosis, treatment, monitoring, and so forth, with practicality and operability as prominent features.

Efficacy and safety of ivermectin for the treatment of COVID-19: a systematic review and meta-analysis

BACKGROUND

Ivermectin became a popular choice for COVID-19 treatment among clinicians and the public following encouraging results from pre-print trials and in vitro studies. Early reviews recommended the use of ivermectin based largely on non-peer-reviewed evidence, which may not be robust. This systematic review and meta-analysis assessed the efficacy and safety of ivermectin for treating COVID-19 based on peer-reviewed randomized controlled trials (RCTs) and observational studies (OSs).

METHODS

MEDLINE, EMBASE and PubMed were searched from 1 January 2020 to 1 September 2021 for relevant studies. Outcomes included time to viral clearance, duration of hospitalization, mortality, incidence of mechanical ventilation and incidence of adverse events. RoB2 and ROBINS-I were used to assess risk of bias. Random-effects meta-analyses were conducted. GRADE was used to evaluate quality of evidence.

RESULTS

Three OSs and 14 RCTs were included in the review. Most RCTs were rated as having some concerns in regards to risk of bias, while OSs were mainly rated as having a moderate risk of bias. Based on meta-analysis of RCTs, the use of ivermectin was not associated with reduction in time to viral clearance, duration of hospitalization, incidence of mortality and incidence of mechanical ventilation. Ivermectin did not significantly increase incidence of adverse events. Meta-analysis of OSs agrees with findings from RCT studies.

CONCLUSIONS

Based on very low to moderate quality of evidence, ivermectin was not efficacious at managing COVID-19. Its safety profile permits its use in trial settings to further clarify its role in COVID-19 treatment.

PROTOCOL REGISTRATION

The review was prospectively registered in PROSPERO (CRD42021275302).

Formulation of nanopesticide with graphene oxide as the nanocarrier of pyrethroid pesticide and its application in spider mite control

Nanopesticides with controlled release can achieve more effective utilization of pesticides. Here, to enhance the adsorption of pesticides onto the target organisms, the formulation of pesticides with temperature-responsive release was proposed by combing graphene oxide (GO) and existing pyrethroid pesticides (cyhalothrin, bifenthrin and fenpropathrin). Pesticides were loaded onto GO nanosheets as a carrier via a simple physisorption process, and the GO–pesticide nanocomposites exhibited temperature-responsive release and excellent storage stability, which are of vital importance to the practical application. Furthermore, we assessed the bioactivity of the GO–pesticide nanocomposites against spider mites (Tetranychus urticae Koch) indoors and in the field. As a result, GO–pesticide nanocomposites had many folds higher bioactivity than individual pesticides, and could be adsorbed on the cuticle of T. urticae and surface of bean leaves with highly uniform dispersibility. The easy preparation and higher bioactivity of GO–pesticide nanocomposites indicate their promising application potential in pest control and green agriculture.

Nanopesticides with controlled release can achieve more effective utilization of pesticides.

[Determination of Three Types of New Psychoactive Tryptamines in Blood by QuEChERS Combined with UPLC-MS/MS]

Objective To establish a method combining QuEChERS and ultra-high liquid chromatography-tandem mass spectrometry （UPLC-MS/MS） for rapid screening and testing of three types of new psychoactive tryptamines in human blood： 5-MeO-DALT, 5-MeO-MiPT and 5-MeO-DiPT. Methods The effects of the type of extractant, the type and dosage of salting-out agent, and the dosage of adsorbent on the test results of the three tryptamines were investigated. Blood samples were processed by QuEChERS method and then determined by UPLC-MS/MS. Results The linear relationships of 5-MeO-DALT, 5-MeO-MiPT and 5-MeO-DiPT in human blood were good in the range of 0.5-100, 0.5-100 and 0.2-100 ng/mL, respectively, with their coefficients higher than 0.99. The limits of detection （LODs） were 0.1-0.2 ng/mg. The recoveries ranged from 84.86% to 94.57%. Intra-day and inter-day precisions were good. Conclusion The method is simple, rapid, easy to operate and has a high recovery. It is suitable for the qualitative and quantitative study of tryptamines in blood and can provide the reference for public security organs to deal with related cases.

[Preliminary study on the etiological characteristics and clinical treatment of medication-related osteonecrosis of the jaws]

Objective: To summarize the etiological characteristics and clinical treatment effects of 17 patients with medication-related osteonecrosis of the jaw (MRONJ). Methods: The clinical data of 17 patients with MRONJ admitted to the Department of Oral and Maxillofacial Surgery, the First People's Hospital of Jinzhong, Shanxi Province, from July 2016 to December 2019 were retrospectively analyzed, including 9 males and 8 females, aged (63.6±9.6) years old (43-82 years old). Descriptive analysis of the primary disease, onset factors, site of disease, clinical manifestations, treatment methods, and treatment effects was conducted through follow-up for at least 1 year. Results: Among the primary diseases of the 17 cases, 12 were malignant tumors, and 5 were osteoporosis. There were 13 cases with a history of a trigger event (tooth extraction or unsuited removable denture). Six cases occurred in the maxilla, 10 cases occurred in the mandible, and 1 case involved both the upper and lower jaws. For the most common medication used, bisphosphonate was used in 16 cases including 5 cases with concomitant use of angiogenesis-inhibiting drugs. There was 1 case resulted from receptor activator of NF-κB ligand (RANKL) monoclonal antibody application. The duration of medication application was (10.1±3.9) months (3-18 months). All 17 cases were treated surgically. Totally 15 patients healed well after surgical treatment and the other 2 patients, who had poor soft tissue healing after surgery, healed well after a second operation. Conclusions: Tooth extraction might be a major trigger factor for the onset of MRONJ in the mandible. The disease was more possibly occured in the mandible than in the maxilla. Appropriate surgical treatment could achieve a good clinical outcome.

[Preparation of doxorubicin-loaded metallic organic nanoparticles and their effect for enhancing efficacy of high-intensity focused ultrasound therapy in tumor-bearing mice]

OBJECTIVE

To prepare metallic organic nanoparticles that produce synergistic effect in high-intensity focused ultrasound (HIFU) therapy of tumors.

OBJECTIVE

Glucose oxidase (GOD), MnO₂, ferric iron (Fe³⁺) and doxorubicin (DOX) were self-assembled by physical adsorption with previously prepared manganese dioxide (MnO₂) nanoparticles to obtain GOD-MnO₂-Fe³⁺-DOX nanoparticles (GMFD NPs). HepG2 tumor-bearing nude mouse models were given intravenous injections of normal saline or GMFD NPs followed 4 h later by HIFU at the acoustic power of 90 W with a total treatment time of 3 s. The changes of tumor gray value before and after HIFU irradiation were observed and 24 h after HIFU irradiation, coagulation necrosis in the tumor tissues was examined; the histological changes of the tumor tissues were observed with HE staining.

OBJECTIVE

We successfully prepared GMFD NPs, which had an average particle size of 131.23±0.84 nm with a surface potential of 21.87±1.72 mV. GMFD NPs, with a drug loading rate of 40.18%, was capable of releasing more than 77.2% of the loaded DOX within 4 h in acidic environment. In the tumor-bearing mouse models, HIFU irradiation following GMFD NP injection, as compared with saline injection, resulted in significantly enhanced gray value of the tumor (25.5±4.5 vs 18.7±3.9, P=0.04) and greater volume of coagulation necrosis (105.80 ± 1.21 mm³ vs 38.02 ± 0.34 mm³). The energy efficiency factor (EEF) was significantly lower in GMFD NPs group than in saline group (1.79 vs 4.97, P < 0.001).

OBJECTIVE

GMFD NPs prepared in this study can enhance tumor ablation efficacy of HIFU and release DOX for further treatment of the residual tumor tissue in mice.

Initial chest radiograph scores inform COVID-19 status, intensive care unit admission and need for mechanical ventilation

AIM

To evaluate whether portable chest radiography (CXR) scores are associated with coronavirus disease 2019 (COVID-19) status and various clinical outcomes.

MATERIALS AND METHODS

This retrospective study included 500 initial CXR from COVID-19-suspected patients. Each CXR was scored based on geographic extent and degree of opacity as indicators of disease severity. COVID-19 status and clinical outcomes including intensive care unit (ICU) admission, mechanical ventilation, mortality, length of hospitalisation, and duration on ventilator were collected. Multivariable logistic regression analysis was performed to evaluate the relationship between CXR scores and COVID-19 status, CXR scores and clinical outcomes, adjusted for code status, age, gender and co-morbidities.

RESULTS

The interclass correlation coefficients amongst raters were 0.94 and 0.90 for the extent score and opacity score, respectively. CXR scores were significantly (p < 0.01) associated with COVID-19 positivity (odd ratio [OR] = 1.49; 95% confidence interval [CI]: 1.27 - 1.75 for extent score and OR = 1.75; 95% CI: 1.42 - 2.15 for opacity score), ICU admission (OR = 1.19; 95% CI: 1.09 - 1.31 for extent score and OR = 1.26; 95% CI: 1.10 - 1.44 for opacity score), and invasive mechanical ventilation (OR = 1.22; 95% CI: 1.11 - 1.35 for geographic score and OR = 1.21; 95% CI: 1.05 - 1.38 for opacity score). CXR scores were not significantly different between survivors and non-survivors after adjusting for code status (p>0.05). CXR scores were not associated with length of hospitalisation or duration on ventilation (p>0.05).

CONCLUSIONS

Initial CXR scores have prognostic value and are associated with COVID-19 positivity, ICU admission, and mechanical ventilation.

Label-free proteomics study on Shewanella putrefaciens regulated by ε-poly-lysine treatment

AIMS

The purpose of this study was to investigate the regulatory mechanism of ε-PL on Shewanella putrefaciens.

METHODS AND RESULTS

Proteomics analysis of inhibitory effect of ε-PL against S. putrefaciens was performed by label-free quantitative assay based on high-resolution mass spectrometry (MS). Quantification of 2206 proteins was obtained with high confidence, and a total of 36 differentially expressed proteins (DEPs), with 10 and 26 proteins showing upregulation and downregulation, respectively, were identified. Upon Go functional enrichment, 11, 5 and 8 specific Go terms in biological processes, molecular functions and cellular components were identified, respectively. Six KEGG pathways, including 'ribosome', were significantly enriched. Among the ribosome pathway, there were seven DEPs and all of them were distributed on large and small subunits of ribosome.

CONCLUSIONS

The significant downregulation of proteins, large subunits of ribosomal proteins RP-L18, L30 and L27, small subunits ribosomal proteins S16 and S20, and RNA polymerase β' subunit protein rpoC were the critical action sites of ε-PL to inhibit S. putrefaciens growth.

SIGNIFICANCE AND IMPACT OF THE STUDY

Shewanella putrefaciens is one of the representative fish-spoilage bacteria regardless of fish type, and poses significant problems for the fish brewery. A better understanding of the antibacterial mechanism of ε-PL on S. putrefaciens could make important contributions to development of biological control strategies of these economically important pathogens.

Anticoagulation for mechanical aortic valve replacement: an international survey

Introduction

Mechanical valves are preferred over biologic valves in younger patients because they are more durable but require long-term anticoagulation which increases the risk of bleeding. For patients with a mechanical aortic valve, the ACCP guidelines recommend a target INR of 2.5 (range 2.0–3.0) for all patients, whereas the ACC/AHA and ESC guidelines recommend a higher target for selected patients with additional risk factors for thromboembolism (TE). Data supporting the guideline recommendations are largely historical and of low quality.

Purpose

We surveyed physicians who manage anticoagulation for patient with mechanical heart valves to determine their usual practice, perceptions regarding guideline recommendations, and interest in participating in a randomized controlled trial (RCT) comparing lower with higher INR targets in patients with a mechanical aortic valve.

Methods

A 33-question web-based survey was sent to 75 cardiologists, cardiac surgeons and thrombosis specialists at centres in Canada and internationally (western Europe, South America, and the United States) who participated in previous anticoagulation trials led by investigators at McMaster University.

Results

Of the 55 respondents (73.3% response rate), 77.8% worked in academic teaching hospitals. Respondents had been in practice for a mean of 23.6 years; 40.9% followed AHA/ACC guidelines, 34.1% followed the ACCP guidelines and 22.7% followed the ESC guidelines. In patients with a mechanical aortic valve and no additional TE risk factors, 80% of respondents targeted an INR of 2.5 (range 2.0–3.0); among patients with additional TE risk factors, 48% targeted an INR of 2.5 (range 2.0–3.0) and 44% targeted an INR of 3.0 (range 2.5–3.5). With respect to guidelines: 57.1% of respondents agreed or strongly agreed that that the evidence for the guidelines was contemporary, 53.1% agreed or strongly agreed that the evidence was derived from patients with modern bi-leaflet mechanical valves, and 57.2% of respondents agreed or strongly agreed that the evidence was not of high quality. A majority of respondents (65.9%) reported that they would accept an increase in TE risk to reduce the risk of a major bleeding event; 86.4% are willing to randomize patients with a mechanical aortic valve to a target INR of 2.0 (range 1.5–2.5) if they had no risk factors for TE and 36.4% would randomize patients to a target INR of 2.0 with additional risk factors for TE.

Conclusions

Clinicians who participated in the survey followed different guidelines and employed different INR targets for patients with a mechanical aortic valve. A majority of respondents would be willing to randomize these patients to lower INR targets.

Mechanical Aortic Valves and INR Targets

Funding Acknowledgement

Type of funding source: None

Effect Of Transtibial Prosthesis Mass On Gait Asymmetries

BACKGROUND

Individuals with transtibial amputation (TTA) typically walk with an asymmetrical gait pattern, which may predispose them to secondary complications and increase risk of fall. Gait asymmetry may be influenced by prosthesis mass.

OBJECTIVES

To explore the effects of prosthesis mass on temporal and limb loading asymmetry in people with TTA following seven days of acclimation and community use.

METHODOLOGY

Eight individuals with transtibial amputation participated. A counterbalanced repeated measures study, involving three sessions (each one week apart) was conducted, during which three load conditions were examined: no load, light load and heavy load. The light load and heavy load conditions were achieved by adding 30% and 50% of the mass difference between legs, at a proximal location on the prosthesis. Kinematic and ground reaction force data was captured while walking one week after the added mass. Symmetry indices between the prosthetic and intact side were computed for temporal (Stance and Swing time) and limb loading measures (vertical ground reaction force Peak and Impulse).

FINDINGS

Following seven days of acclimation, no significant differences were observed between the three mass conditions (no load, light load and heavy load) for temporal (Stance time: p=0.61; Swing time: p=0.13) and limb loading asymmetry (vertical ground reaction force Peak: p=0.95; vertical ground reaction force Impulse: p=0.55).

CONCLUSIONS

Prosthesis mass increase at a proximal location did not increase temporal and limb loading asymmetry during walking in individuals with TTA. Hence, mass increase subsequent to replacing proximally located prosthesis components may not increase gait asymmetry, thereby allowing more flexibility to the clinician for component selection.

[Study on the role and possible mechanism of hemeoxygenase-1/carbon monoxide system in protection of quercetin against ethanol-induced hepatocytes oxidative injury]

Objective: To study the protective effect and potential mechanism of heme oxygenase (HO-1)/carbon monoxide (CO)-mediated quercetin on alcoholic oxidative damage of primary rat hepatocytes. Methods: Primary rat hepatocytes were isolated and cultured by two-step collagenase technique. Ethanol exposed primary rat hepatocytes were simultaneously added with quercetin (100 μmol/L) and/or hemoglobin (100 μmol/L) or different doses of CO-releasing molecules (CORM-2, 5-50 μmol/L) for their combined action. After polling, LDH, AST activities and MDA and GSH levels were measured in the supernatant of cell culture. The alone or combined effects of quercetin, CORM-2, hemoglobin and zinc protoporphyrin IX exposed to ethanol were detected by the activity of CYP2E1 in liver microsomes. Statistical analysis of data was performed by analysis of variance (ANOVA) and intergroup comparison was done by SNK-test. Results: Simultaneous addition of 100 μmol/L quercetin had significantly reduced ethanol-induced AST and LDH release, and GSH consumption and MDA elevation extent. Moreover, quercetin had not only lost the hemoglobin (CO blocker) protective effect but also had further exacerbated ethanol-induced lipid peroxidation. CORM-2 had reduced ethanol-induced AST and LDH release, and GSH consumption and MDA production in liver cells, and thus had dose-dependent protective effect. Ethanol had increased significantly CYP2E1 activity. Quercetin or CORM-2 had inhibited CYP2E1 activity, while hemoglobin or protoporphyrin IX had eliminated quercetin inhibitory effect and had increased the CYP2E1 activity. Quercetin, and CYP2E1 activity was constant as compared to ethanol group when CORM-2, zinc protoporphyrin IX and ethanol were incubated with hepatocytes, but the CYP2E1 activity was significantly decreased (P < 0.05), and the differences were statistically significant. Conclusion: CO/HO-1 metabolite mediates the protective effect of quercetin on alcoholic oxidative damage of hepatocytes, which may be related to the inhibition of CYP2E1 activity.

The most useful cranial ultrasound predictor of neurodevelopmental outcome at 2 years for preterm infants

AIM

To determine the most important cranial ultrasound predictors of abnormality associated with neurodevelopmental outcome at 2 years of age in preterm infants.

MATERIALS AND METHODS

A total of 343 preterm infants born between 2005 and 2010 and cared for in KK Women's and Children's Hospital, a tertiary paediatric hospital, with birth weight ≤1,250 g were assessed in this retrospective study. Serial cranial ultrasound examinations were examined for intraventricular haemorrhage and cystic periventricular leukomalacia. Ventricular-brain ratio on term equivalent cranial ultrasound was measured. Neurodevelopmental outcome was assessed by the performance on Bayley Scales of Infant and Toddler Development, 3^rd edition (Bayley-III) at 2 years corrected age. Mental delay was defined as having a combined Bayley-III score (the average of cognitive and language scores) <80.

RESULTS

The mean cognitive, language, and motor scores on Bayley-III in this cohort were 93±15, 83±18, and 92±15, respectively. Twenty-six percent of the preterm infants had mental delay and 4% had cerebral palsy. Ventricular-brain ratio >0.35 was the most significant factor associated with mental delay (odds ratio 5.28, 95% CI: 1.49-18.71, p=0.01). Other significant risk factors for mental delay were male gender, postnatal steroids, and necrotising enterocolitis, whereas maternal tertiary education was a protective factor against adverse outcome.

CONCLUSION

Ventricular-brain ratio >0.35 on term-equivalent cranial ultrasound in preterm infants is the strongest predictor for mental delay on Bayley score at 2 years of age.