Mesenchymal Stem Cells-Derived Exosomes Alleviate Acute Lung Injury by Inhibiting Alveolar Macrophage Pyroptosis

Acute lung injury (ALI) is an important pathological process of acute respiratory distress syndrome, yet there are limited therapies for its treatment. Mesenchymal stem cells-derived exosomes (MSCs-Exo) have been shown to be effective in suppressing inflammation. However, the effects of MSCs-Exo on ALI and the underlying mechanisms have not been well elucidated. Our data showed that MSCs-Exo, but not exosomes derived from MRC-5 cells (MRC-5-Exo), which are human fetal lung fibroblast cells, significantly improved chest imaging, histological observations, alveolocapillary membrane permeability, and reduced inflammatory response in ALI mice model. According to miRNA sequencing and proteomic analysis of MSCs-Exo and MRC-5-Exo, MSCs-Exo may inhibit pyroptosis by miRNAs targeting caspase-1-mediated pathway, and by proteins with immunoregulation functions. Taken together, our study demonstrated that MSCs-Exo were effective in treating ALI by inhibiting the pyroptosis of alveolar macrophages and reducing inflammation response. Its mechanism may be through pyroptosis-targeting miRNAs and immunoregulating proteins delivered by MSCs-Exo. Therefore, MSCs-Exo may be a new treatment option in the early stage of ALI.

Laparoscopic intraperitoneal onlay mesh (IPOM) with fascial repair (IPOM-plus) for ventral and incisional hernia: a systematic review and meta-analysis

PURPOSE

Despite advancements in laparoscopic ventral hernia repair (LVHR) using the intraperitoneal onlay mesh technique (sIPOM), recurrence remains a common postoperative complication. The objective of this systematic review and meta-analysis is to compare the efficacy of defect closure (IPOM-plus) versus non-closure in ventral and incisional hernia repair. The aim is to determine which technique yields better outcomes in terms of reducing recurrence and complication rates.

METHODS

A comprehensive literature review was conducted in the PubMed, Web of Science, Cochrane Library, Embase, and ClinicalTrials.gov databases from their inception until October 1, 2022, to identify all online English publications that compared the outcomes of laparoscopic ventral hernia repair with and without fascia closure.

RESULTS

Three randomized controlled trials (RCTs) and eleven cohort studies involving 1585 patients met the inclusion criteria. The IPOM-plus technique was found to reduce the recurrence of hernias (OR = 0.51, 95% CI [0.35, 0.76], p < 0.01), seroma (OR = 0.48, 95% CI [0.32, 0.71], p < 0.01), and mesh bulging (OR = 0.08, 95% CI [0.01, 0.42], p < 0.01). Subgroup analysis revealed that body mass index (BMI) (OR = 0.43, 95% CI [0.29, 0.65], p < 0.0001), type of article (OR = 0.51, 95% CI [0.35, 0.76], p = 0.0008 < 0.01), geographical location (OR = 0.54, 95% CI [0.36, 0.82], p = 0.004 < 0.01), follow-up time (OR = 0.50, 95% CI [0.34, 0.73], p = 0.0004 < 0.01) had a significant influence on the postoperative recurrence of the IPOM-plus technique.

CONCLUSION

The IPOM-plus technique has been shown to greatly reduce the occurrence of recurrence, seroma, and mesh bulging. Overall, the IPOM-plus technique is considered a safe and effective procedure. However, additional randomized controlled studies with extended follow-up periods are necessary to further evaluate the IPOM-plus technique.

Accelerating Structural Optimization through Fingerprinting Space Integration on the Potential Energy Surface

Structural optimization has been a crucial component in computational materials research, and structure predictions have relied heavily on this technique, in particular. In this study, we introduce a novel method that enhances the efficiency of local optimization by integrating extra fingerprint space into the optimization process. Our approach utilizes a mixed energy concept in the hyper potential energy surface (PES), combining real energy and a newly introduced fingerprint energy derived from the symmetry of the local atomic environment. This method strategically guides the optimization process toward high-symmetry, low-energy structures by leveraging the intrinsic symmetry of the atomic configurations. The effectiveness of our approach was demonstrated through structural optimizations of silicon, silicon carbide, and Lennard-Jones cluster systems. Our results show that the fingerprint space biasing technique significantly enhances the performance and probability of discovering energetically favorable, high-symmetry structures as compared to conventional optimizations. The proposed method is anticipated to streamline the search for new materials and facilitate the discovery of novel energetically favorable configurations.

Bound-State Breaking and the Importance of Thermal Exchange-Correlation Effects in Warm Dense Hydrogen

Hydrogen at extreme temperatures and pressures is of key relevance for cutting-edge technological applications, with inertial confinement fusion research being a prime example. In addition, it is ubiquitous throughout our universe and naturally occurs in a variety of astrophysical objects. In the present work, we present exact ab initio path integral Monte Carlo (PIMC) results for the electronic density of warm dense hydrogen along a line of constant degeneracy across a broad range of densities. Using the well-known concept of reduced density gradients, we develop a new framework to identify the breaking of bound states due to pressure ionization in bulk hydrogen. Moreover, we use our PIMC results as a reference to rigorously assess the accuracy of a variety of exchange-correlation (XC) functionals in density functional theory calculations for different density regions. Here, a key finding is the importance of thermal XC effects for the accurate description of density gradients in high-energy-density systems. Our exact PIMC test set is freely available online and can be used to guide the development of new methodologies for the simulation of warm dense matter and beyond.

"Triple-low" radiation dose bronchial artery CT angiography before bronchial artery embolisation: a feasibility study

AIM

To explore the feasibility of a "triple-low" dose (low tube voltage, low tube current, and low contrast agent volume) bronchial artery computed tomography (CT) angiography (CTA) to replace routine dose bronchial artery CTA before bronchial artery embolisation (BAE).

MATERIALS AND METHODS

CTA was obtained from 60 patients with body mass index (BMI) < 30 kg/m2 using a 256 multi-section iCT system, and they were divided into two groups: (1) group A: 100 kVp, 100 mAs, 50 ml contrast medium (CM); (2) group B: 120 kVp, automatic tube current modulation (ACTM), 80 ml CM. CT attenuation of the thoracic aorta, image noise, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated, and subjective image quality scores and traceability scores assessed. The effective radiation dose was calculated.

RESULTS

The radiation dose was reduced by 79.7% in group A compared to group B (p<0.05). The CT attenuation of the thoracic aorta was increased by approximately 13% in group A compared to group B (p<0.05). Higher image noise, lower SNR, and CNR were obtained in group A compared to group B (all p<0.05). Both subjective image quality scores and traceability scores did not differ between groups A and B (both p>0.05).

CONCLUSION

It is feasible to use the "triple-low" dose CTA protocol for patients with a body mass index (BMI) < 30 kg/m2. The radiation dose was reduced by 79.7%, and the dose of contrast medium was reduced by 37.5% to ensure the diagnostic value.

Entropy is a good approximation to the electronic (static) correlation energy

For an electronic system, given a mean field method and a distribution of orbital occupation numbers that are close to the natural occupations of the correlated system, we provide formal evidence and computational support to the hypothesis that the entropy (or more precisely -σS, where σ is a parameter and S is the entropy) of such a distribution is a good approximation to the correlation energy. Underpinning the formal evidence are mild assumptions: the correlation energy is strictly a functional of the occupation numbers, and the occupation numbers derive from an invertible distribution. Computational support centers around employing different mean field methods and occupation number distributions (Fermi-Dirac, Gaussian, and linear), for which our claims are verified for a series of pilot calculations involving bond breaking and chemical reactions. This work establishes a formal footing for those methods employing entropy as a measure of electronic correlation energy (e.g., i-DMFT [Wang and Baerends, Phys. Rev. Lett. 128, 013001 (2022)] and TAO-DFT [J.-D. Chai, J. Chem. Phys. 136, 154104 (2012)]) and sets the stage for the widespread use of entropy functionals for approximating the (static) electronic correlation.

Retrospective analysis of medical emergencies in an oral emergency department

BACKGROUND

To retrospectively analyze the rescue of medical emergencies and critical patients in the oral emergency department in a hospital during the past 14 years; analyze the general condition of patients, their diagnosis, etiological factors, and outcomes of the disease, so as to improve the ability of oral medical staff to deal with emergencies; and optimize the emergency procedures and resource allocation in such departments.

MATERIAL AND METHODS

Data and related information of critical patient emergency rescue from the Emergency Department of the Hospital of Stomatology, Peking University from January 2006 to December 2019, were analyzed.

RESULTS

A total of 53 critical patients were rescued in the oral emergency department in the past 14 years, which is an average of four cases per year, with an incidence rate of 0.00506%. The main type of emergency included hemorrhagic shock and active hemorrhage, with the highest incidence being in the age group of 19-40 years old. Among these cases, 67.92% (36/53) developed emergency and critical diseases before visiting the oral emergency department and 41.51% (22/53) had systemic diseases. After rescue, a total of 48 patients (90.57%) had stable vital signs and 5 (9.43%) died.

CONCLUSIONS

Oral doctors and other medical staff should be able to rapidly identify medical emergencies in oral emergency departments and commence emergency treatment. The department should be equipped with relevant first-aid drugs and devices, and medical staff should be regularly trained in practical first-aid skills. Patients with oral and maxillofacial trauma, massive hemorrhage and systemic diseases should be evaluated and treated according to their conditions and systemic organ function to prevent and reduce medical emergencies.

Machine learning electronic structure methods based on the one-electron reduced density matrix

The theorems of density functional theory (DFT) establish bijective maps between the local external potential of a many-body system and its electron density, wavefunction and, therefore, one-particle reduced density matrix. Building on this foundation, we show that machine learning models based on the one-electron reduced density matrix can be used to generate surrogate electronic structure methods. We generate surrogates of local and hybrid DFT, Hartree-Fock and full configuration interaction theories for systems ranging from small molecules such as water to more complex compounds like benzene and propanol. The surrogate models use the one-electron reduced density matrix as the central quantity to be learned. From the predicted density matrices, we show that either standard quantum chemistry or a second machine-learning model can be used to compute molecular observables, energies, and atomic forces. The surrogate models can generate essentially anything that a standard electronic structure method can, ranging from band gaps and Kohn-Sham orbitals to energy-conserving ab-initio molecular dynamics simulations and infrared spectra, which account for anharmonicity and thermal effects, without the need to employ computationally expensive algorithms such as self-consistent field theory. The algorithms are packaged in an efficient and easy to use Python code, QMLearn, accessible on popular platforms.

Assessing the feasibility of SUVindex (a metric derived from FDG PET/CT) for the diagnosis of polymyalgia rheumatica

AIM

To evaluate the feasibility of standard uptake value (SUV) index (ratio lesional maximum SUV [SUVmax] to liver mean SUV [SUVmean]) as a metabolic parameter for diagnosing polymyalgia rheumatica (PMR).

MATERIALS AND METHODS

A retrospective group of patients with PMR and controls with symptoms similar to PMR but diagnosed with other diseases. Semiquantitative and qualitative analysis of 2-[18F]-fluoro-2-deoxy-d-glucose (18F-FDG) uptake at 18 sites was undertaken for all patients. The diagnostic value of positron-emission tomography/computed tomography (PET/CT) for PMR was assessed by R software using logistic regression and a generalised additive model (GAM). All images were examined independently by two nuclear medicine physicians with extensive work experience.

RESULTS

The characteristic sites of PMR were the ischial tuberosity, interspinous bursa, periarticular hip, and symphysis pubis enthesis. The area under the curve (AUC) of the characteristic site SUV index was 0.930, and the best cut-off value was 1.685 with a sensitivity of 84.6% and a specificity of 92.6%. After adjusting for potential confounders, the probability of PMR diagnosis increased as the characteristic site SUV index increased and there was a nonlinear correlation between the two. When the characteristic site SUV index was ≥2.56, the probability of PMR gradually reached the threshold effect, which was as high as 90% or more.

CONCLUSION

The characteristic site SUV index is an independent factor for diagnosing PMR, and PMR should be highly suspected when it is ≥ 1.685. Nonetheless, it is important to note that these findings are based on an initial retrospective single-centre study and require external validation and further prospective evaluation before being translated into clinical practice.

Breast cancer diagnosis and prognosis using a high b-value non-Gaussian continuous-time random-walk model

AIM

To compare the diagnostic performance of mono-exponential model-derived apparent diffusion coefficient (ADC), continuous-time random-walk (CTRW) model-derived D_m, α, β and their combinations in discriminating malignancy of breast lesions, and investigate the association between model-derived parameters and prognosis-related immunohistochemical indices.

MATERIALS AND METHODS

A total of 85 patients with breast lesions (51 malignant, 34 benign) were analysed in this retrospective study. Clinical characteristics include oestrogen receptor (ER), progesterone receptor (PR), human epidermal receptor 2 (HER2), and Ki-67. The ADC was fitted using a mono-exponential model (b-values = 0, 800 s/mm²), while D_m, α, and β were fitted using a CTRW model. Independent Student's t-test and the Mann-Whitney U-test were used for the comparison of parameters. Discrimination performance was accomplished by receiver operating characteristic (ROC) analysis, and Spearman's correlation analysis was used to explore the association between immunohistochemical indices and diffusion parameters, the statistical significance level was p<0.05.

RESULTS

D_m and ADC demonstrated similar performance in differentiating malignant and benign lesions (AUC = 0.928 versus 0.930), while the combination of D_m, α, and β could improve the AUC to 0.969. The combined parameter generated by ADC, D_m, α, and β was effective in identifying the ER+/ER- and PR+/PR- patients. Temporal heterogeneity parameter α correlated significantly with the expression of PR.

CONCLUSION

Diffusion parameters derived from the CTRW model could effectively discriminate the malignancy of breast lesions. Meanwhile, the hormone receptor expression could be distinguished by combined diffusion parameters, and have the potential to reflect the prognosis.

Which Physical Phenomena Determines the Ionization Potential of Liquid Water?

Understanding and predicting the properties of molecular liquids from the corresponding properties of the individual molecules is notoriously difficult because there is cooperative behavior among the molecules in the liquid. This is particularly relevant for water, where even the most fundamental molecular properties, such as the dipole moment, are radically different in the liquid compared to the gas phase. In this work, we focus on the ionization potential (IP) of liquid water by dissecting its individual contributions from the individual molecules making up the liquid. This is achieved by using periodic subsystem DFT, a state-of-the-art electronic structure method based on density embedding. We identify and evaluate four important electronic contributions to the IP of water: (1) mean-field, evaluated at the Hartree-Fock level; (2) electronic correlation, incorporated via DFT and wave function-based methods; (3) interaction with and (4) polarization of the environment, both evaluated ab initio with density embedding. Furthermore, we analyze their impact on the IP relative to the structural fluctuation of liquid water, revealing unexpected, hidden correlations, confirming that the broadening of the photoelectron spectra is mostly caused by intermolecular interactions confined in the first solvation shell.

Pharmacodynamic activity of BMS-986156, a glucocorticoid-induced TNF receptor-related protein agonist, alone or in combination with nivolumab in patients with advanced solid tumors

BACKGROUND

The success of immune checkpoint inhibitors has revolutionized cancer treatment options and triggered development of new complementary immunotherapeutic strategies, including T-cell co-stimulatory molecules, such as glucocorticoid-induced tumor necrosis factor receptor-related protein (GITR). BMS-986156 is a fully agonistic human immunoglobulin G subclass 1 monoclonal antibody targeting GITR. We recently presented the clinical data for BMS-986156 with or without nivolumab, which demonstrated no compelling evidence of clinical activity in patients with advanced solid tumors. Here, we further report the pharmacodynamic (PD) biomarker data from this open-label, first-in-human, phase I/IIa study of BMS-986156 ± nivolumab in patients with advanced solid tumors (NCT02598960).

MATERIALS AND METHODS

We analyzed PD changes of circulating immune cell subsets and cytokines in peripheral blood or serum samples collected from a dataset of 292 patients with solid tumors before and during treatment with BMS-986156 ± nivolumab. PD changes in the tumor immune microenvironment were measured by immunohistochemistry and a targeted gene expression panel.

RESULTS

BMS-986156 + nivolumab induced a significant increase in peripheral T-cell and natural killer (NK) cell proliferation and activation, accompanied by production of proinflammatory cytokines. However, no significant changes in expression of CD8A, programmed death-ligand 1, tumor necrosis factor receptor superfamily members, or key genes linked with functional parameters of T and NK cells were observed in tumor tissue upon treatment with BMS-986156.

CONCLUSIONS

Despite the robust evidence of peripheral PD activity of BMS-986156, with or without nivolumab, limited evidence of T- or NK cell activation in the tumor microenvironment was observed. The data therefore explain, at least in part, the lack of clinical activity of BMS-986156 with or without nivolumab in unselected populations of cancer patients.

Development and validation of risk prediction models for stroke and mortality among patients with type 2 diabetes in northern China

BACKGROUND

Stroke is one of the leading causes of disability and mortality in patients with type 2 diabetes mellitus (T2DM). Risk models have been developed for predicting stroke and stroke-associated mortality among patients with T2DM. Here, we evaluated risk factors of stroke for individualized prevention measures in patients with T2DM in northern China.

METHODS

In the community-based Tianjin Chronic Disease Cohort study, 58,042 patients were enrolled between January 2014 and December 2019. We used multiple imputation (MI) to impute missing variables and univariate and multivariate Cox's proportional hazard regression to screen risk factors of stroke. Furthermore, we established and validated first-ever prediction models for stroke (Model 1 and Model 2) and death from stroke (Model 3) and evaluated their performance.

RESULTS

In the derivation and validation groups, the area under the curves (AUCs) of Models 1-3 was better at 5 years than at 8 years. The Harrell's C-index for all models was above 0.7. All models had good calibration, discrimination, and clinical net benefit. Sensitivity analysis using the MI dataset indicated that all models had good and stable prediction performance.

CONCLUSION

In this study, we developed and validated first-ever risk prediction models for stroke and death from stroke in patients with T2DM, with good discrimination and calibration observed in all models. Based on lifestyle, demographic characteristics, and laboratory examination, these models could provide multidimensional management and individualized risk assessment. However, the models developed here may only be applicable to Han Chinese.

Serum fibrinogen-like protein 1 as a novel biomarker in polycystic ovary syndrome: a case-control study

PURPOSE

To investigate the relationship between fibrinogen-like protein 1 (FGL-1) concentrations and various metabolic characteristics in patients with polycystic ovary syndrome (PCOS) and explore whether FGL-1 could be a predictive biomarker for PCOS.

METHODS

This case-control study included 136 patients with PCOS and 34 normal controls recruited in the Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital between May 2017 and June 2021. Anthropometric characteristics, metabolic parameters, and reproductive hormones were collected. Serum FGL-1 measurement was conducted using enzyme-linked immunosorbent assay (ELISA) kits.

RESULTS

Serum FGL-1 concentrations were higher in patients with PCOS than in control subjects in body mass index (BMI) subgroups, insulin resistance (IR) subgroups, and hepatic function subgroups, respectively. Serum FGL-1 concentrations were significantly associated with BMI, glycosylated hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), homeostasis model assessment of insulin resistance (HOMA-IR), alanine aminotransferase (ALT), aspartate aminotransferase (AST), high-density lipoprotein cholesterol (HDL-c), and serum uric acid (SUA) in all individuals. The receiver operating characteristic (ROC) curve analysis revealed that the best cutoff value for FGL-1 levels to predict PCOS was 21.02 ng/ml with a sensitivity of 74.3% and a specificity of 70.6%. Both univariate and multiple logistic regressions indicated that the odds ratio (OR) for PCOS significantly increased in the subjects with high levels of FGL-1.

CONCLUSION

In our study, FGL-1 was associated with serum aminotransferase and various metabolic indexes. Moreover, the high risk of PCOS was independently associated with the increased FGL-1 levels, which suggested that FGL-1 could be a predictive biomarker for PCOS.

Circ_0039569 contributes to the paclitaxel resistance of endometrial cancer via targeting miR-1271-5p/PHF6 pathway

Circular RNA (circRNA) has been confirmed to be involved in the chemoresistance process of cancers. However, whether circ_0039569 mediates the chemoresistance of endometrial cancer (EC) remains unclear. Quantitative real-time PCR was performed to analyze circ_0039569, microRNA (miR)-1271-5p and PHD finger protein 6 (PHF6) expression. Cell counting kit-8 assay was used to assess the paclitaxel (PTX) resistance of cells. Cell proliferation, apoptosis and invasion were determined using EdU assay, colony formation assay, flow cytometry and transwell assay. Protein expression was examined by western blot analysis. RNA interaction was verified by dual-luciferase reporter assay and RNA pull-down assay. Xenograft tumor models were constructed to explore the effect of circ_0039569 knockdown on the PTX sensitivity of EC tumors. Circ_0039569 was upregulated in PTX-resistant EC tissues and cells. Knockdown of circ_0039569 enhanced the PTX sensitivity of EC cells by inhibiting cell growth and invasion. MiR-1271-5p could be sponged by circ_0039569, and its inhibitor abolished the regulation of circ_0039569 knockdown on the PTX sensitivity of EC cells. PHF6 was targeted by miR-1271-5p, and its overexpression eliminated the promotion effect of miR-1271-5p on the PTX sensitivity of EC cells. Also, interference of circ_0036569 enhanced the PTX sensitivity of EC tumors by regulating the miR-1271-5p/PHF6 pathway. Collectively, circ_0039569 might contribute to the PTX resistance of EC through the regulation of the miR-1271-5p/PHF6 axis.

Adaptive Subsystem Density Functional Theory

Subsystem density functional theory (DFT) is emerging as a powerful electronic structure method for large-scale simulations of molecular condensed phases and interfaces. Key to its computational efficiency is the use of approximate nonadditive noninteracting kinetic energy functionals. Unfortunately, currently available nonadditive functionals lead to inaccurate results when the subsystems interact strongly such as when they engage in chemical reactions. This work disrupts the status quo by devising a workflow that extends subsystem DFT's applicability also to strongly interacting subsystems. This is achieved by implementing a fully automated adaptive definition of subsystems which is realized during geometry optimizations or ab initio molecular dynamics simulations. The new method prescribes subsystem merging and splitting events redistributing the resources (both for work and data) in an efficient way making use of modern parallelization strategies and object-oriented programming. We showcase the method with examples probing from moderate-to-strong inter-subsystem interactions, opening the door to using subsystem DFT for modeling chemical reactions in molecular condensed phases with a black box computational tool.

Density Embedding Method for Nanoscale Molecule-Metal Interfaces

In this work, we extend the applicability of standard Kohn-Sham DFT (KS-DFT) to model realistically sized molecule-metal interfaces where the metal slabs venture into the tens of nanometers in size. Employing state-of-the-art noninteracting kinetic energy functionals, we describe metallic subsystems with orbital-free DFT and combine their electronic structure with molecular subsystems computed at the KS-DFT level resulting in a multiscale subsystem DFT method. The method reproduces within a few millielectronvolts the binding energy difference of water and carbon dioxide molecules adsorbed on the top and hollow sites of an Al(111) surface compared to KS-DFT of the combined supersystem. It is also robust for Born-Oppenheimer molecular dynamics simulations. Very large system sizes are approached with standard computing resources thanks to a parallelization scheme that avoids accumulation of memory at the gather-scatter stage. The results as presented are encouraging and open the door to ab initio simulations of realistically sized, mesoscopic molecule-metal interfaces.

Quantitative structure-activity relationship modeling reveals the minimal sequence requirement and amino acid preference of sirtuin-1's deacetylation substrates in diabetes mellitus

Sirtuin 1 (SIRT1) is a nicotinamide adenine dinucleotide (NAD[Formula: see text]-dependent deacetylase involved in multiple glucose metabolism pathways and plays an important role in the pathogenesis of diabetes mellitus (DM). The enzyme specifically recognizes its deacetylation substrates' peptide segments containing a central acetyl-lysine residue as well as a number of amino acids flanking the central residue. In this study, we attempted to ascertain the minimal sequence requirement (MSR) around the central acetyl-lysine residue of SIRT1 substrate-recognition sites as well as the amino acid preference (AAP) at different residues of the MSR window through quantitative structure-activity relationship (QSAR) strategy, which would benefit our understanding of SIRT1 substrate specificity at the molecular level and is also helpful to rationally design substrate-mimicking peptidic agents against DM by competitively targeting SIRT1 active site. In this procedure, a large-scale dataset containing 6801 13-mer acetyl-lysine peptides (and their SIRT1-catalyized deacetylation activities) were compiled to train 10 QSAR regression models developed by systematic combination of machine learning methods (PLS and SVM) and five amino acids descriptors (DPPS, T-scale, MolSurf, [Formula: see text]-score, and FASGAI). The two best QSAR models (PLS+FASGAI and SVM+DPPS) were then employed to statistically examine the contribution of residue positions to the deacetylation activity of acetyl-lysine peptide substrates, revealing that the MSR can be represented by 5-mer acetyl-lysine peptides that meet a consensus motif X[Formula: see text]X[Formula: see text]X[Formula: see text](AcK)₀X[Formula: see text]. Structural analysis found that the X[Formula: see text] and (AcK)₀ residues are tightly packed against the enzyme active site and confer both stability and specificity for the enzyme-substrate complex, whereas the X[Formula: see text], X[Formula: see text] and X[Formula: see text] residues are partially exposed to solvent but can also effectively stabilize the complex system. Subsequently, a systematic deacetylation activity change profile (SDACP) was created based on QSAR modeling, from which the AAP for each residue position of MSR was depicted. With the profile, we were able to rationally design an SDACP combinatorial library with promising deacetylation activity, from which nine MSR acetyl-lysine peptides as well as two known SIRT1 acetyl-lysine peptide substrates were tested by using SIRT1 deacetylation assay. It is revealed that the designed peptides exhibit a comparable or even higher activity than the controls, although the former is considerably shorter than the latter.

A symmetry-orientated divide-and-conquer method for crystal structure prediction

Crystal structure prediction has been a subject of topical interest but remains a substantial challenge especially for complex structures as it deals with the global minimization of the extremely rugged high-dimensional potential energy surface. In this paper, a symmetry-orientated divide-and-conquer scheme was proposed to construct a symmetry tree graph, where the entire search space is decomposed into a finite number of symmetry dependent subspaces. An artificial intelligence-based symmetry selection strategy was subsequently devised to select the low-lying subspaces with high symmetries for global exploration and in-depth exploitation. Our approach can significantly simplify the problem of crystal structure prediction by avoiding exploration of the most complex P1 subspace on the entire search space and has the advantage of preserving the crystal symmetry during structure evolution, making it well suitable for predicting the complex crystal structures. The effectiveness of the method has been validated by successful prediction of the candidate structures of binary Lennard-Jones mixtures and the high-pressure phase of ice, containing more than 100 atoms in the simulation cell. The work therefore opens up an opportunity toward achieving the long-sought goal of crystal structure prediction of complex systems.

Mediating Effects of Malnutrition on the Relationship between Depressive Symptoms Clusters and Muscle Function Rather than Muscle Mass in Older Hemodialysis Patients

OBJECTIVES

The purpose of this study was to investigate the association and mediation pathways among muscle mass, muscle function (muscle strength and physical performance), and malnutrition with depressive symptoms clusters in the older hemodialysis patients.

DESIGN

A multi-center cross-sectional study.

SETTING AND PARTICIPANTS

A total of 499 patients aged ≥ 60 on hemodialysis from seven facilities in Shanghai of China from 2020 to 2021.

MEASUREMENTS

Muscle mass was assessed by skeletal muscle index(SMI). Muscle strength was measured by handgrip strength, and physical performance was measured via gait speed and Timed Up and Go Test (TUGT). Nutritional status was assessed by Malnutrition Inflammation Score (MIS). Depressive symptoms were evaluated by the Patient Health Questionnaire-9 (PHQ-9). Logistic regression and mediation analyses fully adjusted for all potential confounding factors.

RESULTS

Among 499 participants (312 men, mean age 69.2±6.6 years), 108 (21.6%) had depressive symptoms. The muscle strength, physical performance and malnutrition were associated with depressive symptoms. Furthermore, malnutrition significantly mediated the association of muscle function with total, cognitive-affective symptoms. The association of the muscle function with somatic symptoms were mediated by the nutritional status. The mediated proportions of malnutrition in the relationship between physical performance and depressive symptoms clusters were stronger in somatic symptoms than in cognitive-affective symptoms.

CONCLUSIONS

Our findings suggest that muscle function rather than muscle mass may contribute substantially to the development of depressive symptoms clusters in the hemodialysis via malnutrition. The malnutrition mediated stronger in the association of muscle function with somatic symptoms. These findings may help guide clinicians to better diagnose and manage depression in the context of concomitant muscle function and malnutrition.

GGA-Level Subsystem DFT Achieves Sub-kcal/mol Accuracy Intermolecular Interactions by Mimicking Nonlocal Functionals

The key feature of nonlocal kinetic energy functionals is their ability to reduce to the Thomas-Fermi functional in the regions of high density and to the von Weizsäcker functional in the region of low-density/high reduced density gradient. This behavior is crucial when these functionals are employed in subsystem DFT simulations to approximate the nonadditive kinetic energy. We propose a GGA nonadditive kinetic energy functional which mimics the good behavior of nonlocal functionals, retaining the computational complexity of typical semilocal functionals. Crucially, this functional depends on the inter-subsystem density overlap. The new functional reproduces Kohn-Sham DFT and benchmark CCSD(T) interaction energies of weakly interacting dimers in the S22-5 and S66 test sets with a mean absolute deviation well below 1 kcal/mol.

Efficient DFT Solver for Nanoscale Simulations and Beyond

We present the one-orbital ensemble self-consistent field (OE-SCF), an alternative orbital-free DFT solver that extends the applicability of DFT to beyond nanoscale system sizes, retaining the accuracy required to be predictive. OE-SCF treats the Pauli potential as an external potential updating it iteratively, dramatically outperforming current solvers because only few iterations are needed to reach convergence. OE-SCF enabled us to carry out the largest ab initio simulations for silicon-based materials to date by employing only 1 CPU. We computed the energy of bulk-cut Si nanoparticles as a function of their diameter up to 16 nm, and the polarization and interface charge transfer when a Si slab is sandwiched between two metal slabs where lattice matching mandated a large contact area. Additionally, OE-SCF opens the door to adopting even more accurate functionals in orbital-free DFT simulations while still tackling large system sizes.

A vascularized bone graft harvested from the dorsal base of the third metacarpal bone for the treatment of scaphoid nonunion

The purpose of this retrospective study was to introduce the use of an alternative vascularized bone graft for treating scaphoid non-union. The vascularized bone graft was harvested from the dorsal base of the third metacarpal bone. From May 2014 to September 2017, 29 patients with scaphoid non-union were treated. Grip and pinch strengths were compared to the contralateral side. The patients rated wrist joint pain on a visual analogue scale. Wrist function was assessed on Mayo Wrist Score. p < 0.05 was considered statistically significant. 18 scaphoids healed at 6 weeks and the other 11 at 16 weeks. Follow-up ranged from 28 to 73 months, for a mean 48 months. At final follow-up, mean wrist flexion had improved from 65° (range, 51°-81°) preoperatively to 72° (range, 61-78°) (p > 0.05), for a contralateral value of 74° (range, 65°-86°). Mean extension had improved from 56° (range, 44°-72°) to 60° (range, 47°-76°) (p > 0.05) for a contralateral value of 66° (range, 52°-80°). Mean wrist pain improved from 4 (range, 3-8) to 2 (range, 0-4) (p < 0.05). Mean pinch strength improved from 6.4 kg (range, 5.2-7.3 kg) to 8.6 kg (6.1-9.9 kg) (p < 0.05). Mayo Wrist Score improved from 49 (range, 10-65) to 92 (range, 70-100) (p < 0.05). Transferring a vascularized bone graft harvested from the base of the third metacarpal bone was an effective alternative for the treatment of scaphoid non-union, achieving bone healing and normal wrist function without significant donor-site morbidity. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.

MiR-133 inhibits kidney injury in rats with diabetic nephropathy via MAPK/ERK pathway

OBJECTIVE

The aim of this study was to explore the effect of micro ribonucleic acid (miR)-133 on kidney injury in rats with diabetic nephropathy (DN) through the mitogen-activated protein kinase/extracellular signal-regulated kinase (MAPK/ERK) pathway.

MATERIALS AND METHODS

The model of DN was first established in rats. Blood glucose, renal index, urinary micro-albumin (UMA), and creatinine clearance rate (CCr) were detected. Meanwhile, the protein expression levels of miR-133, kidney injury molecule-1 (KIM-1) and anti-inflammatory cytokine interleukin-8 (IL-8) were measured using Western blotting. Human renal proximal tubular epithelial cell line human kidney-2 (HK-2) was treated with high glucose to simulate DN cells in vivo. Subsequently, Western blotting was performed to detect the protein expression of KIM-1. After HK-2 cells were treated with high glucose and silenced miR-133 for 24 h, the expression changes in KIM-1 was evaluated.

RESULTS

In DN group, blood glucose, renal index, UMA, and CCr were all markedly higher than those of control group. This indicated the successful establishment of DN model in rats. The expression level of miR-133 was significantly up-regulated in DN model rats. Meanwhile, the downstream protein phosphorylated-EPK (p-EPK) showed a significantly increasing trend as well. Additionally, the protein expressions of KIM-1 and IL-8 were notably elevated. High-glucose-treated HK-2 cells showed significantly up-regulated expression levels of miR-133, KIM-1, and IL-8. After 24 h of combined treatment with high glucose and miR-133 silence, the expressions of KIM-1 and IL-8 were markedly down-regulated.

CONCLUSIONS

MiR-133 may be related to the occurrence and development of DN. The silence of miR-133 inhibits kidney injury in DN via the MAPK/ERK signaling pathway. Our findings suggest that miR-133 may be an effective target for the treatment of DN.

Experimental observation of Faraday waves in soft gels

We report the experimental observation of Faraday waves on soft gels. These were obtained using agarose in a mechanically vibrated cylindrical container. Low driving frequencies induce subharmonic standing waves with spatial structure that conforms to the geometry of the container. We report the experimental observation of the first 15 resonant Faraday wave modes that can be defined by the mode number (n,ℓ) pair. We also characterize the shape of the instability tongue and show the complex dependence upon material properties can be understood as an elastocapillary effect.

Immediate versus delayed induction of labour in hypertensive disorders of pregnancy: a systematic review and meta-analysis

Background

Mothers with hypertensive disorder of pregnancy can be managed with either immediate or delayed induction of labour with expectant monitoring of both mother and baby. There are risks and benefits associated with both the type of interventions. Hence, this review was conducted to compare outcomes of immediate and delayed induction of labour among women with hypertensive disorder of pregnancy based on disease severity and gestational age.

Methods

We conducted systematic searches in various databases including Medline, Cochrane Controlled Register of Trials (CENTRAL), Scopus, and Embase from inception until October 2019.Cochrane risk of bias tool was used to assess the quality of published trials. A meta-analysis was performed with random-effects model and reported pooled Risk ratios (RR) with 95% confidence intervals (CIs).

Results

Fourteen randomized controlled trials with 4244 participants were included. Majority of the studies had low or unclear bias risks. Amongst late onset mild pre-eclampsia patients, the risk of renal failure was significantly lower with immediate induction of labour (pooled RR: 0.36; 95%CI: 0.14 to 0.92). In severe pre-eclampsia patients, immediate induction of labour significantly reduced the risk of having small-for-gestational age babies compared to delayed induction of labour (pooled RR: 0.49; 95%CI: 0.29–0.84).Delayed induction was found to significantly reduce the risk of neonatal respiratory distress syndrome risk among late onset mild pre-eclampsia patients (pooled RR: 2.15; 95%CI: 1.14 to 4.06) None of the other outcomes demonstrated statistically significant difference between the two interventions.

Conclusion

Delayed induction of labour with expectant monitoring may not be inferior to immediate induction of labour in terms of neonatal and maternal outcomes. Expectant approach of management for late onset mild pre-eclampsia patients may be associated with decreased risk of neonatal respiratory distress syndrome, while immediate induction of labour among severe pre-eclampsia patients is associated with reduced risk of small-for-gestational age babies and among mild pre-eclampsia patients, it is associated with reduced risk of severe renal impairment.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12884-020-03407-8.

Association between cigarette smoking and the susceptibility of acute myeloid leukemia: a systematic review and meta-analysis

OBJECTIVE

To elucidate the association between cigarette smoking and the susceptibility of acute myeloid leukemia (AML).

MATERIALS AND METHODS

We searched relevant articles from PubMed, Embase, and Cochrane by 1st December, 2018. This meta-analysis included 20 case-control studies, involving 7,538 AML patients and 137,924 healthy controls. Studies reported OR and 95%CI of the correlation between cigarette smoking and AML susceptibility were eligible. Subsequently, the included data were weighted by an inverse variance and analyzed using fixed-effects or random-effects model. Subgroup analysis was conducted based on ethnicities and sources of controls. Heterogeneity test was applied for the included articles. Data analyses were conducted using STATA 12.0.

RESULTS

Current smokers (OR=1.42, 95%CI= 1.28-1.57; p=0.392) and ever-smokers (OR=1.16, 95%CI=1.05-1.28; p=0.036) were associated with AML susceptibility. In the subgroup analysis by ethnicity, only current smokers (OR=1.45, 95%CI=1.29-1.63; p=0.371) and ever-smokers (OR=1.16, 95%CI=1.03-1.30; p=0.034) of the Caucasian population were associated with AML susceptibility. Stratified analysis based on SOC (source of controls) indicated increased susceptibility of AML in current smokers (OR=1.43, 95%CI=1.26-1.63; p=0.283) and ever-smokers (OR=1.20, 95%CI=1.07-1.35; p=0.078) of the population-based group. Nevertheless, only current smokers in the hospital-based group had increased susceptibility of AML (OR=1.45, 95%CI=1.19-1.76; p=0.198). The risks of AML in ever-smokers (OR=1.04, 95%CI = 0.81-1.35; p=0.054) of the hospital-based group did not remarkably changed.

CONCLUSIONS

In this meta-analysis, we confirmed the association between cigarette smoking and onset risk of AML, especially in the Caucasian population. High-quality, large-scale researches are required to be conducted in multi-center hospitals for verification.

Pressure-stabilized divalent ozonide CaO3 and its impact on Earth's oxygen cycles

High pressure can drastically alter chemical bonding and produce exotic compounds that defy conventional wisdom. Especially significant are compounds pertaining to oxygen cycles inside Earth, which hold key to understanding major geological events that impact the environment essential to life on Earth. Here we report the discovery of pressure-stabilized divalent ozonide CaO3 crystal that exhibits intriguing bonding and oxidation states with profound geological implications. Our computational study identifies a crystalline phase of CaO3 by reaction of CaO and O2 at high pressure and high temperature conditions; ensuing experiments synthesize this rare compound under compression in a diamond anvil cell with laser heating. High-pressure x-ray diffraction data show that CaO3 crystal forms at 35 GPa and persists down to 20 GPa on decompression. Analysis of charge states reveals a formal oxidation state of -2 for ozone anions in CaO3. These findings unravel the ozonide chemistry at high pressure and offer insights for elucidating prominent seismic anomalies and oxygen cycles in Earth's interior. We further predict multiple reactions producing CaO3 by geologically abundant mineral precursors at various depths in Earth's mantle.

Detection of the mesenchymal-to-epithelial transition of invasive non-small cell lung cancer cells by their membrane undulation spectra

A cancer cell changes its state from being epithelial- to mesenchymal-like in a dynamic manner during tumor progression. For example, it is well known that mesenchymal-to-epithelial transition (MET) is essential for cancer cells to regain the capability of seeding on and then invading secondary/tertiary regions. However, there is no fast yet reliable method for detecting this transition. Here, we showed that membrane undulation of invasive cancer cells could be used as a novel marker for MET detection, both in invasive model cell lines and repopulated circulating tumor cells (rCTCs) from non-small cell lung cancer (NSCLC) patients. Specifically, using atomic force microscopy (AFM), it was found that the surface oscillation spectra of different cancer cells, after undergoing MET, all exhibited two distinct peaks from 0.001 to 0.007 Hz that are absent in the spectra before MET. In addition, by adopting the long short-term memory (LSTM) based recurrent neural network learning algorithm, we showed that the positions of recorded membrane undulation peaks can be used to predict the occurrence of MET in invasive NSCLC cells with high accuracy (>90% for model cell lines and >80% for rCTCs when benchmarking against the conventional bio-marker vimentin). These findings demonstrate the potential of our approach in achieving rapid MET detection with a much reduced cell sample size as well as quantifying changes in the mesenchymal level of tumor cells.

[Risk factors and clinical features of hospital-associated venous thromboembolism]

Objective: To investigate the clinical features and risk factors of hospital-associated venous thromboembolism (VTE). Methods: The study enrolled acute VTE patients admitted into China-Japan Friendship Hospital from January 1, 2017 to December 31, 2017. The hospital-associated VTE (HA-VTE) group and the community-associated VTE (CA-VTE) group were classified according to whether the VTE occurred during hospitalization or within a 90-day period of admission to hospital (including inpatient with at least two days of hospital stay or a surgical procedure under general or regional anaesthesia). Differences in clinical features, risk factors, and mortality rate were compared between the two groups. Results: A total of 437 patients with acute VTE were analyzed in the study. Among them, 266 patients were HA-VTE, 171 patients were CA-VTE. Patients in the CA-VTE group were more likely to have varicose veins, sedentary, long-distance travel, and patients in the HA-VTE group were more complicated with recent surgery (<1 month), bed rest, active malignant tumor, acute infections, acute cerebral infarction, fracture, central venous catheter (P<0.05). The CA-VTE group had more clinical symptoms such as lower extremity pain, dyspnea, chest pain and chest tightness (P<0.05). HA-VTE patients had less clinical symptoms but were more severe than the CA-VTE patients, with more sudden deaths (0 vs 3.4%, P=0.035). Among HA-VTE patients, 92.8% experienced VTE during hospitalization or within 1 month of the preceding hospital encounter, with a 13-day median time to VTE. The all-cause mortality rate was higher for HA-VTE group than CA-VTE group (8.3% vs 1.2%, P<0.001), and the in-hospital VTE was more common compared to VTE diagnosed post-discharge (12.2% vs 3.4%, P<0.001). Conclusions: More than half events of VTE are related to recent hospitalizations. HA-VTE has different risk factors from CA-VTE, combined with fewer clinical symptoms but higher all-cause mortality rate. More attention about VTE should be paid to hospitalized patients to reduce the incidence of HA-VTE events.

Efficient potential-tuning strategy through p-type doping for designing cathodes with ultrahigh energy density

Designing new cathodes with high capacity and moderate potential is the key to breaking the energy density ceiling imposed by current intercalation chemistry on rechargeable batteries. The carbonaceous materials provide high capacities but their low potentials limit their application to anodes. Here, we show that Fermi level tuning by p-type doping can be an effective way of dramatically raising electrode potential. We demonstrate that Li(Na)BCF₂/Li(Na)B₂C₂F₂ exhibit such change in Fermi level, enabling them to accommodate Li⁺(Na⁺) with capacities of 290–400 (250–320) mAh g⁻¹ at potentials of 3.4–3.7 (2.7–2.9) V, delivering ultrahigh energy densities of 1000–1500 Wh kg⁻¹. This work presents a new strategy in tuning electrode potential through electronic band structure engineering.

Envelopes in multivariate regression models with nonlinearity and heteroscedasticity

Envelopes have been proposed in recent years as a nascent methodology for sufficient dimension reduction and efficient parameter estimation in multivariate linear models. We extend the classical definition of envelopes in Cook et al. (2010) to incorporate a nonlinear conditional mean function and a heteroscedastic error. Given any two random vectors ${X}\in\mathbb{R}^{p}$ and ${Y}\in\mathbb{R}^{r}$, we propose two new model-free envelopes, called the martingale difference divergence envelope and the central mean envelope, and study their relationships to the standard envelope in the context of response reduction in multivariate linear models. The martingale difference divergence envelope effectively captures the nonlinearity in the conditional mean without imposing any parametric structure or requiring any tuning in estimation. Heteroscedasticity, or nonconstant conditional covariance of ${Y}\mid{X}$, is further detected by the central mean envelope based on a slicing scheme for the data. We reveal the nested structure of different envelopes: (i) the central mean envelope contains the martingale difference divergence envelope, with equality when ${Y}\mid{X}$ has a constant conditional covariance; and (ii) the martingale difference divergence envelope contains the standard envelope, with equality when ${Y}\mid{X}$ has a linear conditional mean. We develop an estimation procedure that first obtains the martingale difference divergence envelope and then estimates the additional envelope components in the central mean envelope. We establish consistency in envelope estimation of the martingale difference divergence envelope and central mean envelope without stringent model assumptions. Simulations and real-data analysis demonstrate the advantages of the martingale difference divergence envelope and the central mean envelope over the standard envelope in dimension reduction.

Open reduction and internal fixation obtains favorable clinical and radiographic outcomes for pediatric mandibular condylar fractures

PURPOSE

Surgery with open reduction internal fixation (ORIF) for pediatric mandibular condylar fractures (MCF) is controversial. This study aims to evaluate the clinical and radiographic outcomes of the children with MCF treated surgically with ORIF.

METHODS

This retrospective study included 9 children diagnosed with MCF and treated surgically with ORIF. Imaging examinations were performed preoperatively and postoperatively. Patients underwent follow-up clinical observations and objective measurements for over 5 years.

RESULTS

All children recovered well in facial features, facial nerve functions, occlusions, joint movements, maximal incisal opening, and midline deviation postoperatively. The temporomandibular joint (TMJ) pain and click were found in 2 of 9 (22.2%) cases 1 year after surgery and disappeared 2 years later. Mandibular retrusion was always observed in a child (11.1%) postoperatively. The condylar surface appeared unsmooth in panoramic radiographs of 2 (22.2%) cases. Objective measurements showed that a patent (11.1%) had an opening deflection and a limited laterotrusion at the return visits. SNB angles of all cases were within the normal range 5 years after the operation.

CONCLUSION

Surgery with ORIF is a relatively safe and effective method for pediatric MCF. The future growth of the mandibular condyle and the long-term TMJ function are lightly influenced in patients postoperatively.

Thumb lengthening using a three-dimensional half-ring distraction frame

The purpose of this study was to evaluate the use of a three-dimensional half-ring distraction frame for thumb phalangeal lengthening. From February 2009 to March 2015, 23 patients (23 thumbs) with thumb loss were treated with a half-ring distraction frame. Active movements of the metacarpophalangeal (MCP) joint were measured with a goniometer. These measurements were compared with the opposite hand. Differences were considered statistically significant at p<0.05. Clinical outcome was assessed based on the modified Mayo score. Bone union and good alignment were achieved in all patients. The mean distraction time was 44 days (range, 35-62 days). The mean time to union was 20 days (range, 49-86 days). The mean palmar and radial abduction of the thumb was 60° (range, 53°-65°) and 63° (range, 58°-70°), respectively; on the uninjured side, these measurements were 62° (range, 56°-65°) and 64° (range, 60°-73°), respectively (p>0.05). The mean extension-flexion arc of the MCP joint was 46° (range, 40°-50°); the measurement on the uninjured side was 48° (40°-54°) (p>0.05). The mean follow-up period was 51 months (4.25 years) (range, 48-65 months). The mean modified Mayo Score was 138 (range, 113-145). There were 19 excellent, 3 good, and 1 fair results. The half-ring distraction frame is a viable alternative for thumb lengthening as it provides stable, three-dimensional fixation, resulting in good hand function.

A method for determining surface tension, viscosity, and elasticity of gels via ultrasonic levitation of gel drops

A method for obtaining the elasticity, surface tension, and viscosity of ultrasonically levitated gel drops is presented. The drops examined were made of agarose, a hydrogel. In contrast to previous studies where fluid properties are obtained using ultrasonic levitation of a liquid drop, herein the material studied was a gel which has a significant elasticity. The work presented herein is significant in that gels are of growing importance in biomedical applications and exhibit behaviors partially determined by their elasticities and surface tensions. Obtaining surface tension for these substances is important but challenging since measuring this quantity using the standard Wilhelmy plate or DuNuoy ring methods is not possible due to breakage of the gel. The experiments were conducted on agarose gels having elasticities ranging from 12.2 to 200.3 Pa. A method is described for obtaining elasticity, surface tension, and viscosity, and the method is experimentally demonstrated for surface tension and viscosity. For the range of elasticities explored, the measured surface tension ranged from 0.1 to 0.3 N/m, and the viscosity ranged from 0.0084 to 0.0204 Pa s. The measurements of surface tension are, to the authors' knowledge, the first obtained of a gel using ultrasonic levitation.

Breastfeeding is associated with reduced risk of multiple sclerosis in males, predominantly among HLA-DRB1*15:01 carriers

BACKGROUND

Breastfeeding as an infant appears protective against later development of some autoimmune diseases, but research into its influence on multiple sclerosis (MS) risk has yielded inconclusive results.

OBJECTIVE

We investigated the possible impact of breastfeeding on MS risk.

METHODS

We used two population-based case-control studies comprising 3670 cases and 6737 matched controls. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for association between MS and exposure to prolonged breastfeeding (4 months or longer) versus reduced breastfeeding (less than 4 months). A meta-analysis of case-control studies that assessed the impact of breastfeeding on MS risk among women and men was conducted.

RESULTS

Prolonged breastfeeding was associated with reduced MS risk among men (OR 0.7, 95% CI 0.5-0.9) but not among women (OR 0.9, 95% CI 0.8-1.1). Among men, a synergistic effect was observed between HLA-DRB1*15:01 carrier status and reduced breastfeeding.

CONCLUSIONS

Findings from the current study add to accumulating evidence that breastfeeding may be a modifiable protective factor for reducing the risk of MS in offspring. When possible, mothers should be supported to breastfeed their infants; however, the mechanism of a sex-specific biologic effect of breastfeeding on MS risk is unclear.

Testing conditional mean independence for functional data

We propose a new nonparametric conditional mean independence test for a response variable $Y$ and a predictor variable $X$ where either or both can be function-valued. Our test is built on a new metric, the so-called functional martingale difference divergence, which fully characterizes the conditional mean dependence of $Y$ given $X$ and extends the martingale difference divergence proposed by Shao & Zhang (2014). We define an unbiased estimator of functional martingale difference divergence by using a $\mathcal{U}$-centring approach, and we obtain its limiting null distribution under mild assumptions. Since the limiting null distribution is not pivotal, we use the wild bootstrap method to estimate the critical value and show the consistency of the bootstrap test. Our test can detect the local alternative which approaches the null at the rate of $n^{-1/2}$ with a nontrivial power, where $n$ is the sample size. Unlike the three tests developed by Kokoszka et al. (2008), Lei (2014) and Patilea et al. (2016), our test does not require a finite-dimensional projection or assume a linear model, and it does not involve any tuning parameters. Promising finite-sample performance is demonstrated via simulations, and a real-data illustration is used to compare our test with existing ones.

Ab initio electronic structure calculations using a real-space Chebyshev-filtered subspace iteration method

Ab initio electronic structure calculations within Kohn-Sham density functional theory requires a solution for the Kohn-Sham equation. However, the traditional self-consistent field (SCF) approach of solving the equation using iterative diagonalization exhibits an inherent cubic scaling behavior and becomes prohibitive for large systems. The Chebyshev-filtered subspace iteration (CheFSI) method holds considerable promise for large-system calculations by substantially accelerating the SCF procedure. Here, we employed a combination of the real space finite-difference formulation and CheFSI to solve the Kohn-Sham equation, and implemented this approach in ab initio Real-space Electronic Structure (ARES) software in a multi-processor, parallel environment. An improved scheme was proposed to generate the initial subspace of Chebyshev filtering in ARES efficiently, making it suitable for large-scale simulations. The accuracy, stability, and efficiency of the ARES software were illustrated by simulations of large-scale crystalline systems containing thousands of atoms.

Elastocapillary Transition in Gel Drop Oscillations

We report experimental observations of surface oscillations in an ultrasoft agarose gel drop. Ultrasonic levitation is used to excite shape oscillations in the gel drop and we report the natural frequency of the drop as it depends upon a nondimensional elastocapillary number, which we define as the ratio of the elastocapillary length to drop size. Our experiments span a wide range of experimental parameters and we recover the appropriate scaling laws in the elastic and capillary wave limits. The crossover between these two limits is observed and agrees well with a proposed frequency relationship.

Polyethylene Glycol-Na+ Interface of Vanadium Hexacyanoferrate Cathode for Highly Stable Rechargeable Aqueous Sodium-Ion Battery

Vanadium hexacyanoferrate (VHCF) with an open-framework crystal structure is a promising cathode material for rechargeable aqueous metal-ion batteries owing to its high electrochemical performance and easy synthesis. In this paper, vanadium hexacyanoferrate cathodes were first used for constructing rechargeable aqueous sodium-ion batteries (VHCF/WO₃) and tested in the new-type electrolyte (NaP-4.6) consisting of a polyethylene glycol (PEG)/H₂O/NaClO₄ electrolyte with a low H⁺ concentration (molar ratio of [H₂O]/[Na⁺] is 4.6), which has high stability at a high current density as high as 1000 mA g^-1 with a capacity retention of 90.3% after 2000 cycles at high coulombic efficiency (above 97.8%). To understand their outstanding performance, the proton-assisted sodium-ion storage mechanism and interphase chemistry of VHCF are investigated by solid-state NMR (ssNMR) technology. It is suggested that the H⁺ storage reaction is accompanied by the redox of vanadium atoms and Na⁺ intercalation is accompanied by the redox of iron atoms. It is also observed that the complex of polyethylene glycol (PEG) with Na⁺ (PEG-Na⁺) exists on the VHCF surface, which facilitates the stability of VHCF and promotes the alkali-ion transfer at a high current density. The results of the ssNMR study offer new insights into the intercalation chemistry of Prussian blue analogues with open-framework-structured compounds, which can greatly broaden our horizons for battery research.

Using tongue depressors to aid cord localization during collagenase injection for Dupuytren disease

The aim of this paper was to introduce a simple and effective method to aid in isolation and stabilization of Dupuytren cords for collagenase injection. Tongue depressors were used to isolate and stabilize the cord during the injection procedure. The area to be injected was sterilely prepared. An assistant was then directed to place a tongue depressor on both sides of the cord. A total of 35 patients with Dupuytren disease were treated. Follow-up lasted two years. Post-operative Disabilities of the Arm, Shoulder and Hand (DASH) scores was 4±2. Health-related quality of life measured with the EQ-5D index was 0.89±0.4. Recurrence rates of metacarpophalangeal joint and proximal interphalangeal joint were 11% and 14% respectively, using a flexion contracture of 20° to define recurrence. Collagenase treatment using a modified injection method with the aid of tongue depressors are a safe, effective way to treat Dupuytren contractures of the fingers. The technique can isolate the cord, which improves visualization of the cord. It may allow improved accuracy with needle placement and helps to decrease the complications and recurrence.

Anti-epidermal growth factor receptor (EGFR) monoclonal antibody combined with cisplatin and 5-fluorouracil in patients with metastatic nasopharyngeal carcinoma after radical radiotherapy: a multicentre, open-label, phase II clinical trial

BACKGROUND

We conducted a single-arm phase II trial to evaluate the efficacy and adverse effects (AEs) of an anti-epidermal growth factor receptor monoclonal antibody, nimotuzumab, combined with cisplatin and 5-fluorouracil (PF) as first-line treatment in recurrent metastatic nasopharyngeal carcinoma after radical radiotherapy.

METHODS

Patients who met the eligibility criteria were recruited from ten institutions (ClinicalTrials.gov; NCT01616849). A Simon optimal two-stage design was used to calculate the sample size. All patients received weekly nimotuzumab (200 mg) added to cisplatin (100 mg/m2 D1) and 5-fluorouracil (4 g/m2 continuous infusion D1-4) every 3-weekly for a maximum of six cycles. Primary end point was objective response rate (ORR). Secondary end points included disease control rate (DCR), progression-free survival (PFS), overall survival (OS) and AEs.

RESULTS

A total of 35 patients were enrolled (13 in stage 1 and 22 in stage 2). Overall ORR and DCR were 71.4% (25/35) and 85.7% (30/35), respectively. Median PFS and OS were 7.0 (95% CI 5.8-8.2) months and 16.3 (95% CI 11.4-21.3) months, respectively. Unplanned exploratory analyses suggest that patients who received ≥2400 mg nimotuzumab and ≥4 cycles of PF had superior ORR, PFS and OS than those who did not (88.9% versus 12.5%, P < 0.001; 7.4 versus 2.7 months, P = 0.081; 17.0 versus 8.0 months, P = 0.202). Favourable subgroups included patients with lung metastasis [HROS 0.324 (95% CI 0.146-0.717), P = 0.008] and disease-free interval of >12 months [HROS 0.307 (95% CI 0.131-0.724), P = 0.004], but no difference was observed for metastatic burden. The only major grade 3/4 AE was leukopenia (62.9%).

CONCLUSION

Combination nimotuzumab-PF chemotherapy demonstrates potential efficacy, and is well tolerated as first-line chemotherapy regimen in recurrent metastatic nasopharyngeal carcinoma.