Ischemic stroke pathophysiology: A bibliometric and visualization analysis from 1990 to 2022

Background

Pathophysiology plays a significant role in the scientific study of ischemic stroke, and has attracted increasing interest from researchers in the field. However, a comprehensive bibliometric analysis is lacking in this field. The purpose of this study is to identify the current research status and hotspots of ischemic stroke pathophysiology from a bibliometric perspective.

Methods

The Web of Science Core Collection database was searched for articles published from 1990 to 2022. CiteSpace, VOSviewer, and R package "bibliometrix" software were used to analyze countries/regions, institutions, journals, authors, papers, and keywords to predict the latest trends in ischemic stroke pathophysiology research.

Results

This analysis collected 7578 records of ischemic stroke pathophysiology. China and America emerged as the leading countries in this field, with Harvard University being the most active institution. Among journals and authors in this field, journal Stroke and author Gregory YH Lip published the most papers, while Nature Medicine was the journal with the highest citation per article. Keywords and co-citation clusters were closely related to "central nervous system", "mechanisms", "biochemistry & molecular biology" and "radiology, nuclear medicine & medical imaging", while other related fields, such as peripheral organs damage induced by the central nervous system and rehabilitation after ischemic stroke, require further research efforts.

Conclusion

This is the first bibliometric study that comprehensively mapped out the knowledge structure and development trends of ischemic stroke pathophysiology in recent 32 years, which may provide a reference for scholars to explore ischemic stroke pathophysiology.

Customized development of 3D printed anthocyanin-phycocyanin polychromatic oral film via chondroitin sulfate homeostasis: A platform based on starch and κ-carrageenan

The development of oral film with diverse colors and customized nutrition is in line with the innovation of emerging food. In this study, polychromatic system was formed by regulating the ratio of phycocyanin (PC) to blueberry anthocyanin (BA). Further, chondroitin sulfate (CS) was utilized to achieve color-enhanced and homeostatic effects on PC-BA, and κ-carrageenan (KC) - starch complex was exploited as printing ink to construct oral film system. The color-enhanced effect of CS is mainly related to the complexation of sulfate groups, and the film-forming substrates are combined mainly through hydrogen bonding. In addition, the proportion of KC modulated the gel structure of printing ink, and affected 3D printability and physical properties of oral film. OF II (1.5 % KC content) had a uniform and dense network structure, with the most stable color and the highest BA retention (70.33 %) after 8 d of light exposure. Importantly, OF II had an excellent slow-release effect, and BA release rate was as high as 92.52 %. The optimized components can form polychromatic oral film with controllable color and structure, and provide new insights for the creation of sensory personalized and nutritionally customized food.

Comparing the difference of adverse events with HER2 inhibitors: a study of the FDA adverse event reporting system (FAERS)

Aim and background: This study attempted to identify similarities and differences in adverse events (AEs) between human epidermal growth factor receptor 2 (HER2) inhibitors, especially those related to hemorrhagic events and nervous system disorders. Methods: This study summarized the types, frequencies, and system organ classes (SOCs) of AEs of HER2 inhibitors. The US Food and Drug Administration Adverse Event Reporting System (FAERS) data from January 2004 through March 2022 was collected and analyzed. Disproportionality analyses were conducted to detect AEs signals for every HER2 inhibitor. The chi-square test, Wilcoxon test, and descriptive analysis were used to compare the differences of AEs for specific SOCs or drugs. Results: A total of 47,899 AE reports were obtained for eight HER2 inhibitors. Trastuzumab-related AEs were reported in the highest number and combination of regimens. In monotherapy, trastuzumab had the highest reported rate of cardiac disorders-related AEs (24.0%). However, small-molecule drugs exceeded other drugs in the reported rates of AEs related to gastrointestinal disorders, metabolism and nutrition disorders. The highest reported rates of respiratory disorders (47.3%) and hematologic disorders (22.4%) were associated with treatment with trastuzumab deruxtecan (T-DXd). Patients treated with trastuzumab emtansine (TDM-1) had the highest reported rate (7.28%) of hemorrhagic events, especially intracranial haemorrhage events. In addition, patients treated with TDM-1 with concomitant thrombocytopenia were likely to experience hemorrhagic events compared to other HER2 inhibitors (p < 0.001). The median time to onset of intracranial haemorrhage associated with trastuzumab (0.5 months) and TDM-1 (0.75 months) was short. However, there was no significant difference in median time to onset intracranial haemorrhage between patients in different age groups or with different outcomes. Disproportionality analysis results reveal that cerebral haemorrhage is a positive signal associated with T-DXd and TDM-1. In addition, tucatinib was the drug with the highest rate of reported nervous system disorders (31.38%). Memory impairment (83 cases) is a positive signal for tucatinib. Conclusion: The types and reporting rates of AEs associated with different HER2 inhibitors vary across multiple systems. In addition, hemorrhagic events concomitant with TDM-1 treatment and nervous system disorders concomitant with tucatinib treatment may be worthy of attention.

Bidirectional association between hypothyroidism and myasthenia gravis: a Mendelian randomized study

OBJECTIVES

Although observational studies have suggested a link between hypothyroidism and myasthenia gravis (MG), a causal relationship has not been established. We aimed to investigate the causal association using a two-sample Mendelian randomization (MR) study.

METHODS

Using summary statistics from genome-wide association studies involving 494,577 and 38,243 individuals, single-nucleotide polymorphisms exhibiting no linkage disequilibrium (r2 ≤ 0.001) and displaying significant differences (p ≤ 5 × 10-8) were selected for hypothyroidism and MG. To assess the potential causality relationship between hypothyroidism and MG, MR analysis was conducted using inverse variance weighted (IVW), weighted median method, and MR-Egger. The MR-Egger regression, heterogeneity test, pleiotropy test, and leave-one-out sensitivity test were employed to examine sensitivity analyses. In addition, validation datasets were used to validate the relevant results.

RESULTS

Genetic liability to hypothyroidism was positively associated with MG (IVW, OR: 1.36, 95% CI: 1.17-1.58, p = 7.53 × 10-05; weighted median, OR: 1.19, 95% CI: 0.70-2.02, p = 0.522; MR-Egger, OR: 1.19, 95% CI: 0.98-1.45, p = 0.080). Among the three MR methods, the correlation between hypothyroidism and MG genetic prediction was consistent. The independent validation set (IVW, OR: 466.47, 95% CI: 4.70 -46,285.95, p = 0.01) further supported this. Additionally, bidirectional studies showed that using IVW, there was no reverse causality (OR: 1.104, 95%CI: 0.96-1.27, p = 0.170).

DISCUSSION

This MR study showed that hypothyroidism can increase the risk of MG. Further investigation into the underlying mechanisms of this potential causality is warranted to offer novel therapeutic options for MG in the future.

Structural homeostasis and controlled release for anthocyanin in oral film via sulfated polysaccharides complexation

Oral film is a novel functional carrier, which can provide a new pathway for the efficient absorption of anthocyanin. However, anthocyanin homeostasis in oral film is a prerequisite for achieving efficient absorption and utilization of anthocyanin. Herein, three sulfated polysaccharides, including chondroitin sulfate (CS), fucoidin (FU) and λ-carrageenan (λ-CG), were complexed with blueberry anthocyanin (BA) to prepare oral film formulations using hydroxypropyl methylcellulose (HPMC) as a film-forming matrix. The addition of three sulfated polysaccharides improved the stability of BA in content and color, which were associated with interactions between BA and polysaccharides. The BA retention rate of CS-BA/HPMC system increased 5.5-fold after 8 d of light-accelerated storage compared with the control group, showing the best homeostasis effect. CS and λ-CG enhanced the elongation at break and prolonged disintegration time of oral films. The addition of FU made the oral film denser and smoother, and had the highest BA release (75.72 %) in the simulated oral cavity system. In addition, the oral films of three sulfated polysaccharides complexed with BA showed superior antioxidant capacity. The present study provides new insights into the application of anthocyanin in film formulation carriers.

Dual-function β-cyclodextrin/starch-based intelligent film with reversible responsiveness and sustained bacteriostat-releasing for food preservation and monitoring

The full combination of high sensitivity indication and long-lasting bacteriostatic function is an innovative need to meet the practicality of intelligent film packaging systems for food products. Hence, Blueberry anthocyanins (BA) copigmentated by ferulic acid (FA) was used as an indicator, and cinnamon essential oil (CO) encapsulated by β-cyclodextrin (β-CD) as a bacteriostat, potato starch (PS) as a film-forming substrate to prepared a dual-function starch-based intelligent active packaging film with pH indicator and antibacterial function. FA had the best copigmentation effect with a threefold increase in a value compared to other phenolic acids. The ΔE value increased from 3.24 to 5.13 at pH 2-8, and the change was still prominent in acid-base alternating test, indicating a high response sensitivity. Notably, the yellow gamut of indicating terminus increased its visibility to the naked eye. The release behavior of CO from film was in line with Fick's diffusion. Meanwhile, the release of CO delayed to about 90 h through β-cyclodextrin encapsulation, showing a high growth-inhibition rate in E. coli and S. aureus of almost 100 %. In this study, a dual-function film with indication and bacteriostasis was prepared and enhanced with both, expanding its wide application in intelligent packaging of fresh food.

Evaluation of cardiotoxicity of anthracycline-containing chemotherapy regimens in patients with bone and soft tissue sarcomas: A study of the FDA adverse event reporting system joint single-center real-world experience

OBJECTIVES

To assess the occurrence of cardiotoxicity in patients with tumors receiving anthracycline-based chemotherapy, especially for sarcomas.

METHODS

This study summarized the types and frequency of adverse events (AEs) for three anthracyclines from the FDA adverse event reporting system (FAERS) database. FAERS data from January 2004 to June 2022 were collected and analyzed. Disproportionality analyses, logistic regression, and descriptive analysis were used to compare the differences in cardiac disorders. A retrospective cohort study was conducted in a single center between December 2008 and May 2022. Our hospital-treated patients with bone and soft tissue sarcomas (BSTSs) with anthracycline-containing chemotherapy were analyzed. Serum markers, echocardiography, and electrocardiography have been used to evaluate cardiotoxic events.

RESULTS

One hundred thousand and seventy-five AE reports were obtained for doxorubicin (ADM), epirubicin (EPI), and liposome doxorubicin (L-ADM) from the FAERS database. ADM (OR = 3.1, p < 0.001), EPI (OR = 1.5, p < 0.001), and sarcomas (OR = 1.8, p < 0.001) may increase the probability of cardiac disorders. Cardiac failure, cardiotoxicity, and cardiomyopathy were anthracyclines' top 3 frequent AEs. Among patients receiving ADM-containing therapy, those with ADM applied at doses ≥75 mg/m2 /cycle were more likely to develop cardiac disorders than the other subgroups (OR = 3.5, p < 0.001). Patients younger than 18 are more likely to benefit from dexrazoxane prevention of cardiac failure. Six hundred and eighty-three patients with BSTSs receiving anthracycline-based chemotherapy were analyzed in our center. Patients receiving ADM-containing chemotherapy were likelier to experience abnormalities in serum troponin-T and left ventricular ejection fraction (p < 0.05). 2.0% (6/300) of patients receiving ADM-containing chemotherapy required adjustment of the chemotherapy regimen because of cardiotoxicity, whereas none were in the EPI or L-ADM groups.

CONCLUSIONS AND RELEVANCE

Among patients receiving anthracycline-containing therapy, patients with BSTSs were more likely to develop cardiac disorders than other tumors. In addition, patients with BSTSs receiving ADM chemotherapy had a higher likelihood of cardiotoxic events than those receiving EPI or L-ADM.

A Diagnostic Model for Parkinson's Disease Based on Anoikis-Related Genes

Parkinson's disease (PD) is the second most prevalent neurodegenerative disease, and its pathological mechanisms are thought to be closely linked to apoptosis. Anoikis, a specific type of apoptosis, has recently been suggested to play a role in the progression of Parkinson's disease; however, the underlying mechanisms are not well understood. To explore the potential mechanisms involved in PD, we selected genes from the GSE28894 dataset and compared their expression in PD patients and healthy controls to identify differentially expressed genes (DEGs), and selected anoikis-related genes (ANRGs) from the DEGs. Furthermore, the least absolute shrinkage and selection operator (LASSO) regression approach and multivariate logistic regression highlighted five key genes-GSK3B, PCNA, CDC42, DAPK2, and SRC-as biomarker candidates. Subsequently, we developed a nomogram model incorporating these 5 genes along with age and sex to predict and diagnose PD. To evaluate the model's coherence, clinical applicability, and distinguishability, we utilized receiver operating characteristic (ROC) curves, the C-index, and calibration curves and validated it in both the GSE20295 dataset and our center's external clinical data. In addition, we confirmed the differential expression of the 5 model genes in human blood samples through qRT-PCR and Western blotting. Our constructed anoikis-related PD diagnostic model exhibits satisfactory predictive accuracy and offers novel insights into both diagnosis and treatment strategies for Parkinson's disease while facilitating its implementation in clinical practice.

GPU-enabled real-time optical frequency comb spectroscopy and a photonic readout

We describe a GPU-enabled approach for real-time optical frequency comb spectroscopy in which data is recorded, Fourier transformed, normalized, and fit at data rates up to 2.2 GB/s. As an initial demonstration we have applied this approach to rapidly interrogate the motion of an optomechanical accelerometer through the use of an electro-optic frequency comb. We note that this approach is readily amenable to both self-heterodyne and dual-comb spectrometers for molecular spectroscopy as well as a photonic readout where the approach's agility, speed, and simplicity are expected to enable future improvements and applications.

Colon-targeted delivery of polyphenols: construction principles, targeting mechanisms and evaluation methods

Polyphenols have received considerable attention for their promotive effects on colonic health. However, polyphenols are mostly sensitive to harsh gastrointestinal environments, thus, must be protected. It is necessary to design and develop a colon-targeted delivery system to improve the stability, colon-targeting and bioavailability of polyphenols. This paper mainly introduces research on colon-targeted controlled release of polyphenols. The physiological features affecting the dissolution, release and absorption of polyphenol-loaded delivery systems in the colon are first discussed. Simultaneously, the types of colon-targeted carriers with different release mechanisms are described, and colon-targeting assessment models that have been studied so far and their advantages and limitations are summarized. Based on the current research on polyphenols colon-targeting, outlook and reflections are proposed, with the goal of inspiring strategic development of new colon-targeted therapeutics to ensure that the polyphenols reach the colon with complete bioactivity.

Efficacy of Postoperative Radiotherapy for Patients with New N2 Descriptors of Subclassification in Completely Resected Non-Small Cell Lung Cancer: A Real-World Study

PURPOSE/OBJECTIVE(S)

Patients with N2 non-small cell lung cancer (NSCLC) were heterogeneous groups and required further stratification. The International Society for the Study of Lung Cancer (IASLC) added new descriptors of three sub-stages for stage N2 NSCLC: N2 at a single station without N1 involvement (N2a1), N2 at a single station with N1 involvement (N2a2), and N2 at multiple stations (N2b). This study aimed to investigate the efficacy of postoperative radiotherapy (PORT) for patients with these N2 descriptors.

MATERIALS/METHODS

Patients with histologically confirmed NSCLC after complete resection and divided into PORT group and non-PORT group. The primary endpoint was DFS. The second endpoints were overall survival (OS) and locoregional recurrence-free survival (LRFS). Propensity-score matching (PSM) of baseline characteristics between the PORT and non-PORT groups was used for validation.

RESULTS

Totally 1832 patients were enrolled, including 308 N2a1 patients, 682 N2a2 patients, and 842 N2b patients. The median follow-up time was 50.1 months. The survival outcomes of the PORT and non-PORT groups before PSM were shown in Table 1. For patients with N2a1, PORT could not improve the DFS (median DFS of the PORT group and the non-PORT group: not reached vs. 46.8 months, P = 0.41), OS (P = 0.85), or LRFS (P = 0.32), which were consistent with the multivariate analysis and data after the PSM. For patients with N2a2, PORT significantly improved the DFS (median DFS 29.7 vs. 22.2 months, P = 0.02), OS (P = 0.03), and LRFS (P = 0.01). The multivariate analysis and data after the PSM confirmed the benefits in DFS and LRFS, but no benefit was observed in OS (multivariate analysis: HR 0.79, P = 0.18; median OS after PSM: 103.7 vs. 63.1 months, P = 0.34). For patients with N2b, PORT could not improve the DFS (median DFS 20.6 vs. 21.2 months, P = 0.39) but significantly improved the OS (P<0.001) and LRFS (P<0.001). However, the multivariate analysis showed that PORT significantly improved DFS (HR 0.81, P = 0.03), consistent with the data after the PSM (median DFS 20.6 and 17.6 months, P = 0.04).

CONCLUSION

PORT significantly improved the DFS and LRFS in patients with N2a2 and significantly improved the DFS, LRFS, and OS in patients with N2b. Patients with N2a1 could not benefit from PORT.

Identifying the potential role of serum miR-20a as a biomarker for olfactory dysfunction in patients with Parkinson's disease

INTRODUCTION

Olfactory dysfunction (OD), one of the most common non-motor symptoms in Parkinson's disease (PD), is a cardinal prodromal symptom that can appear years before the onset of motor symptoms. Ongoing studies have demonstrated that microRNAs (miRNAs) are suitable biomarkers for PD, while there is a lack of robust miRNAs that can serve as markers for OD in PD.

METHODS

The concordantly differentially expressed miRNAs (DE miRNAs) in the damaged olfactory system were first identified in 2 OD-related Gene Expression Omnibus (GEO) datasets. Then, they were verified in another PD-related GEO dataset and only one miRNA (miR-20a) was found to be significantly altered. Serum levels of miR-20a were further measured by qPCR in 79 PD patients with OD (PD-OD), 52 PD patients without OD (PD-NOD), and 52 healthy controls (HC). Objective measure of OD was defined by 16-item Sniffin' Sticks odor identification test. All the participants underwent a demographic and comprehensive PD-related clinical assessment.

RESULTS

Our results proved that miR-20a was significantly downregulated in PD-OD compared with PD-NOD and the area under curve (AUC) for OD detection by miR-20a was 0.803 (95% confidence interval, 0.724-0.883). In addition, PD-OD had higher scores of Movement Disorder Society-Unified Parkinson's Disease Rating Scale (UPDRS) II, Hoehn and Yahr stage (H-Y), Non-Motor Symptoms Scale (NMSS) 3, NMSS 5, NMSS 9, Hamilton Rating Scale for Depression (HAMD), Hamilton Anxiety Scale (HAMA), Activity of Daily Living (ADL), and lower scores of Mini-Mental State Examination (MMSE) and 39-item PD Quality of Life Questionnaire (PDQ-39) than PD-NOD. Binary regression model further presented that lower expressions of miR-20a and poorer cognitive function acted as promoting factors in the development of OD.

CONCLUSION

Our results suggest that miR-20a could be a novel biomarker for OD in PD and PD-OD patients tend to have higher disease stage, poorer motor aspects of experiences of daily living, worse cognitive scores, and inferior quality of life, and were more likely to have mental disorders. Cognitive function, in particular, is strongly associated with OD in PD patients.

A Machine Learning Method to Predict Pathological Complete Response of Esophageal Cancer after Neoadjuvant Chemoradiotherapy with Clinicohematological Markers and MR Radiomics: A Multi-Center Study

PURPOSE/OBJECTIVE(S)

Nearly 30% of patients with local advanced esophageal cancer achieved pathological complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT), who may benefit from organ-preservation strategy under accurate prediction of pCR. We aimed to develop and validate machine learning models based on clinicohematological markers and MR radiomics to accurately predict pCR of esophageal cancer after nCRT.

MATERIALS/METHODS

In this multi-center study, eligible patients with esophageal cancer who received baseline MR scan (T2-weighted image) and nCRT plus surgery were enrolled between September 2014 and September 2022 at institution 1 (training set) and between December 2017 and August 2021 at institution 2 (testing set). Pre-nCRT and post-nCRT blood test results were collected to calculate hematological markers. Models were constructed by machine learning based on clinicohematological markers and MR radiomics to predict pCR. Area under the curve (AUC) and cut-off analysis were used to evaluate model performances.

RESULTS

Totally 154 patients (81 in the training set and 73 in the testing set) were enrolled. The combined model integrating pre-nCRT monocyte-to-lymphocyte ratio and 6 radiomics features achieved AUC of 0.800 (95% CI 0.671-0.918) in the testing set, with sensitivity of 79.2% (95% CI 62.5%-95.8%), specificity of 83.7% (95% CI 73.5%-93.9%), positive predictive value of 76.0% (95% CI 62.5%-90.0%), and negative predictive value of 89.6% (95% CI 82.0%-95.8%).

CONCLUSION

A machine learning model based on clinicohematological markers and MR radiomics to predict pCR after nCRT for patients with esophageal cancer was developed and validated, providing a novel tool for personalized treatment. It is necessary to further validate in more large datasets.

Clinical Verification of a Nomogram Model for Prediction of Brain Metastases in Patients with pⅢA-N2 Non-Small Cell Lung Cancer

PURPOSE/OBJECTIVE(S)

Brain metastasis is one of the most common failure patterns of pⅢA-N2 non-small cell lung cancer (NSCLC) after complete resection. Prophylactic Cranial Irradiation (PCI) can improve intracranial control but not overall survival. Thus, it is particularly important to identify risk factors that are associated with brain metastasis and subsequently provide instructions for selecting patients who will optimally benefit from PCI. We have reported a nomogram model which was established based on the condition of histology, bronchial invasion, perineural invasion, and adjuvant chemotherapy, through which we can predict high risk brain metastases in patients with pⅢA-N2 NSCLC. The purpose of this study is to verify the accuracy of the nomogram model by using new cases information.

MATERIALS/METHODS

Between January 1, 2015 and December 31, 2019, patients of pⅢA-N2 NSCLC were retrospectively analyzed, to verify the consistency between actual and predictive brain metastases. The verification group was divided into two groups according to the years when genetic testing has been widely used in clinic (group1:2015-2016, group2:2017-2019). ROC curves and calibration curves were chosen for validation.

RESULTS

A total of 770 patients were enrolled in our retrospective study (group1:294 patients, group2: 476patients). The 1-, 3- and 5-year survival rates were 97.2%, 76.5%, 63.2% in group1, and 95.8%, 84.5%, 76.9% in group2, respectively. The 1-, 3- and 5-year brain metastasis rates were 7.9%, 19.7%, 25.8%, and 5.4%, 14.5%, 26.3% in group2, respectively. The AUC were 0.74 (95% CI:0.72 - 0.76) in group1, and 0.71(95% CI:0.70 - 0.73) in group 2.The 1.3.5-year calibration curves of the two groups show that the prediction is in good agreement with the actual observation.

CONCLUSION

The nomogram model can predict brain metastases high risk patients with pⅢA-N2 NSCLC. Whether gene test or not, it can be used as a basis to screening out patients of high-risk brain metastases in future clinical trials for PCI.

Overall Survival Following Salvage Thoracic Radiotherapy for Locoregional Recurrence in Patients with Completely Resected PIIIA-N2 NSCLC

PURPOSE/OBJECTIVE(S)

Locoregional recurrence is a common failure pattern for patients with completely resected pIIIA-N2 NSCLC. The salvage thoracic radiotherapy is administered in some pIIIA-N2 NSCLC patients despite postoperative radiotherapy (PORT). Salvage thoracic radiotherapy could be well tolerated and might improve survival from several small sample retrospective studies, while the high-level clinical evidence is presently lacking. We conducted this retrospective case control study to demonstrate the efficacy of salvage thoracic radiotherapy for completely resected pIIIA-N2 NSCLC patients with locoregional recurrence.

MATERIALS/METHODS

Between January 2003 and June 2019, patients who had undergone lobectomy or pneumonectomy plus mediastinal lymph node dissection or systematic sampling in our single institution were retrospectively reviewed. Those with pⅢA-N2 NSCLC that did not receive PORT and suffered locoregional recurrence being the first treatment failure were enrolled. The log-rank test was used to analyze differences between the groups, and the Kaplan-Meier method was used for survival analysis. Univariate and multivariate analyses using Cox proportional hazards regression models were performed to evaluate potential prognostic factors for survival. Statistically significant difference was set as p<0.05.

RESULTS

Of all the patients with pⅢA-N2 NSCLC reviewed, 105 suffered locoregional recurrence as the first treatment failure and didn't receive PORT. Among these patients, 51 (48.6%) received salvage thoracic radiotherapy and 54 (51.4%) did not. The median OS was 47.7 months of all patients. Survival analysis showed that the median OS in salvage thoracic radiotherapy group (69.0 months) was significantly longer than that in non-salvage thoracic radiotherapy group (37.7 months) (p = 0.029). For patients of EGFR wild type, salvage thoracic radiotherapy group had significantly longer median OS of 69.0 months compared with non-salvage thoracic radiotherapy group of 31.3 months (p = 0.004). When assessed by histological types, salvage thoracic radiotherapy significantly improved the survival of patients with lung squamous cell carcinoma with median OS not reached compared with non-salvage thoracic radiotherapy group of 31.3 months (p<0.001), while in patients with non-squamous cell carcinoma, this survival benefit was not observed (p = 0.829).

CONCLUSION

Salvage thoracic radiotherapy is an effective treatment for completely resected pIIIA-N2 NSCLC patients that have not received PORT and suffered post-operative locoregional recurrence.

4D printing of biodegradable elastomers with tailorable thermal response at physiological temperature

4D printing has a great potential for the manufacturing of soft robotics and medical devices. The alliance of digital light processing (DLP) 3D printing and novel shape-memory photopolymers allows for the fabrication of smart 4D-printed medical devices in high resolution and with tailorable functionalities. However, most of the reported 4D-printed materials are nondegradable, which limits their clinical applications. On the other hand, 4D printing of biodegradable shape-memory elastomers is highly challenging, especially when transition points close to physiological temperature and shape fixation under ambient conditions are required. Here, we report the 4D printing of biodegradable shape-memory elastomers with tailorable transition points covering physiological temperature, by using poly(D,L-lactide-co-trimethylene carbonate) methacrylates at various monomer feed ratios. After the programming step, the high-resolution DLP printed stents preserved their folded shape at room temperature, and showed efficient shape recovery at 37 °C. The materials were cytocompatible and readily degradable under physiological conditions. Furthermore, drug-loaded devices with tuneable release kinetics were realized by DLP-printing with resins containing polymers and levofloxacin or nintedanib. This study offers a new perspective for the development of next-generation 4D-printed medical devices.

Development of gene model combined with machine learning technology to predict for advanced atherosclerotic plaques

BACKGROUND

Atherosclerosis, as a major cause of stroke, is responsible for a quarter of deaths worldwide. In particular, rupture of late-stage plaques in large vessels such as the carotid artery can lead to serious cardiovascular disease. The aim of our study was to establish a genetic model combined with machining leaning techniques to screen out gene signatures and predict for advanced atherosclerosis plaques.

METHODS

The microarray dataset GSE28829 and GSE43292 which were publicly obtained from the Gene Expression Omnibus database were utilized to screen for potential predictive genes. Differentially expressed genes (DEGs) were identified by using the "limma" R package. Gene Ontology (GO) and Kyoto Encyclopedia of Genes Genomes (KEGG) analyses of these DEGs were performed by Metascape. Later, Random Forest (RF) algorithm was applied to further screen out top-30 genes which contribute the most. The expression data of top 30-DEGs were converted into a "Gene Score". Finally, we developed a model based on artificial neural network (ANN) to predict advanced atherosclerotic plaques. The model later was validated in an independent test dataset GSE104140.

RESULTS

A total of 176 DEGs were identified in the training datasets. GO and KEGG enrichment analysis revealed that these genes were enriched in leukocyte-mediated immune response, cytokine- cytokine interactions, and immunoinflammatory signaling. Further, top-30 genes (including 25 upregulated and 5 downregulated DEGs) were screened as predictors by RF algorithm. The predictive model was developed with a significantly predictive value (AUC = 0.913) in the training datasets, and was validated with an independent dataset GSE104140 (AUC = 0.827).

CONCLUSION

In present study, our prediction model was established and showed satisfactory predictive power in both training and test datasets. In addition, this is the first study adopted bioinformatics methods combined with machine learning techniques (RF and ANN) to explore and predict for the advanced atherosclerotic plaques. However, further investigations were needed to verify the screened DEGs and predictive effectiveness of this model.

Effects of sucrose degradation product furfural on cyanidin-3-O-glucoside: Mechanism of action, stability, and identification of products in sugar solutions

Anthocyanins are often affected by the sweetener sucrose during processing, which is closely related to its typical degradation product, furfural (Ff). However, the specific mechanism is unclear. In this study, Ff and cyanidin-3-O-glucoside (C3G) were used to explain the mechanism of the effect. The results showed that Ff destabilized anthocyanins by chemically reacting with C3G to generate three new adducts. Meanwhile, the color of the C3G solution changed from bright red to dark purple, and the value of the color difference (ΔE) increased significantly by 2.69. Furthermore, the new adducts were less stable than C3G and continued to promote the degradation of C3G when they coexisted with it. The above adducts were also detected in sugar solutions supplemented with C3G, and these adducts were more likely to accumulate under light storage conditions. These results provide a theoretical basis for reducing anthocyanin loss in food processing.

The comparison between zein-anthocyanins complex and nanoparticle systems: Stability enhancement, interaction mechanism, and in silico approaches

This research aimed to compare and characterize the physicochemical properties and interaction mechanism of zein and anthocyanins (ACNs) from experimental and theoretical perspectives. Zein-ACNs complex (ZACP) was prepared by mixing ACNs with different concentrations of zein, and zein-ACNs nanoparticles (ZANPs) were formed using ultrasound-assisted antisolvent precipitation method. The hydrated particle sizes of the two systems were 590.83 nm and 99.86 nm, respectively, and observed to be spherical under transmission electron microscopy (TEM). The multi-spectroscopy approaches confirmed hydrogen bonding and hydrophobic forces were the dominant forces for stabilizing ACNs. The retention of ACNs, color stability and antioxidant activities were also improved in both systems. Furthermore, molecular simulation results were consistent with the multi-spectroscopy findings, which clarified the contribution of van der Waals forces to the binding of zein and ACNs. This study provided a practical approach for stabilizing ACNs and expanding the utilization of plant proteins as stabilization systems.

Detoxification mechanisms of ginseng to aconite: A review

ETHNOPHARMACOLOGICAL RELEVANCE

Aconite (Fuzi, FZ), the processed root tuber of Aconitum carmichaelii Debx., is utilized as a classic medicine to treat diseases of the cardiovascular system and immune system. Resulting from the narrow margin of safety between a therapeutic dose and a toxic dose, FZ often causes cardiotoxicity including hypotension, palpitation, and bradycardia. Contributing to the detoxification effects of the other famous herbal medicine ginseng (Renshen, RS), which is the dried root and rhizome of Panax ginseng C. A. Meyer, people broadly combine FZ and RS as compatibility more than 1800 years to attenuate the toxicity of FZ. However, the systematic detoxification mechanisms of RS to FZ have not been fully revealed.

AIM OF THE REVIEW

Aiming to provide a comprehensive interpretation of the attenuation processes of FZ via RS, this review summarizes the up-to-date information about regulatory mechanisms of RS to FZ to shed the light on the essence of detoxification.

MATERIALS AND METHODS

Literature was searched in electronic databases, including PubMed, Web of Science ScienceDirect, Google Scholar, CNKI and WanFang Data. Relevant studies on detoxification mechanisms were included while irrelevant and duplicate studies were excluded. According to the study design, subject, intervention regime, outcome, first author and year of publication of included data, detoxification mechanisms of RS to FZ were summarized and visualized.

RESULTS

A total of 144 studies were identified through databases from their inception up to Oct. 2022. Included information indicated that diester-diterpenoid alkaloids (DDAs) were the main toxic substances of FZ. The main mechanisms that RS attenuates the toxicity of FZ were transforming toxic compounds of FZ, affecting the absorption and metabolism of FZ as well as the FZ-induced cell toxicity alleviation.

CONCLUSION

FZ, as a famous traditional Chinese medicine, has good prospects for utilization. The narrow margin of safety between a therapeutic dose and a toxic dose of FZ limits its clinical effect and safety while RS is always combined with FZ to alleviate its toxicity. However, mechanisms responsible for the detoxification process have not been well identified. Therefore, detoxification mechanisms of RS to FZ are reviewed to ensure the safety and effectiveness of FZ.

Utilization of ultrasound and glycation to improve functional properties and encapsulated efficiency of proteins in anthocyanins

The purpose of this study is to explore the optimal conditions for the preparation of bovine serum albumin (BSA)/casein (CA)-dextran (DEX) conjugates by ultrasonic pretreatment combined with glycation (U-G treatment). When BSA and CA were treated with ultrasound (40% amplitude, 10 min), the grafting degree increased 10.57% and 6.05%, respectively. Structural analysis revealed that ultrasonic pretreatment changed the secondary structure, further affected functional properties of proteins. After U-G treatment, the solubility and thermal stability of BSA and CA was significantly increased, and the foaming and emulsifying capacity of proteins were also changed. Moreover, ultrasonic pretreatment and glycation exhibited a greater impact on BSA characterized with highly helical structure. Complexes fabricated by U-G-BSA/CA and carboxymethyl cellulose (CMC) exhibited protection on anthocyanins (ACNs), delaying the thermal degradation of ACNs. In conclusion, the protein conjugates treated by ultrasonic pretreatment combined with glycation have excellent functionality and are potential carrier materials.

Single-modulator, direct frequency comb spectroscopy via serrodyne modulation

Traditional electro-optic frequency comb spectrometers rely upon the use of an acousto-optic modulator (AOM) to provide a differential frequency shift between probe and local oscillator (LO) legs of the interferometer. Here we show that these modulators can be replaced by an electro-optic phase modulator (EOM) which is driven by a sawtooth waveform to induce serrodyne modulation. This approach enables direct frequency comb spectroscopy to be performed with a single dual-drive Mach-Zehnder modulator (DD-MZM), allowing for lower differential phase noise. Further, this method allows for simpler production of integrated photonic comb spectrometers on the chip scale.

Association between plasma trimethylamine-N-oxide and cognitive impairment in patients with transient ischemic attack

BACKGROUND

There is increasing evidence for the association of trimethylamine-N-oxide (TMAO) with cognitive impairment after minor stroke or transient ischemic attack (TIA). However, how TMAO affects cognitive function in TIA patients has seldom been studied.

METHODS

A total of 310 TIA participants were retrospectively collected from our stroke register between January 2020 and July 2021. Plasma TMAO was measured by liquid chromatography‒mass spectrometry at baseline. Cognitive performance was assessed by neuropsychological evaluation at 3 months after TIA onset.

RESULTS

A total of 310 patients were included (mean age, 74 years; male, 160 [51.6%]; mean ABCD2 score, 2.6). TMAO was positively associated with cognitive impairment after TIA (aOR, 1.423; 95% CI, 1.125-2.561). The highest quartile of TMAO was related to an almost 2-fold increased risk of cognitive decline compared to the lowest quartile. Furthermore, executive and memory function were more susceptible to impairment after TIA in groups with higher levels of TMAO. Mediation analysis revealed that the overall mediated effect was-0.347 (p < 0.001), and the intermediary effect of CRP was-0.108.

CONCLUSION

Plasma TMAO at baseline was independently associated with cognitive impairment at the 3-month follow-up after TIA. In addition, the inflammatory marker CRP may serve as an important mediator in this relationship. Our study may provide some insights into anti-inflammatory therapy to improve the cognitive trajectory of TIA patients with high TMAO levels.

Parkinson's Disease Gene Biomarkers Screened by the LASSO and SVM Algorithms

Parkinson's disease (PD) is a common progressive neurodegenerative disorder. Various evidence has revealed the possible penetration of peripheral immune cells in the substantia nigra, which may be essential for PD. Our study uses machine learning (ML) to screen for potential PD genetic biomarkers. Gene expression profiles were screened from the Gene Expression Omnibus (GEO). Differential expression genes (DEGs) were selected for the enrichment analysis. A protein-protein interaction (PPI) network was built with the STRING database (Search Tool for the Retrieval of Interacting Genes), and two ML approaches, namely least absolute shrinkage and selection operator (LASSO) and support vector machine recursive feature elimination (SVM-RFE), were employed to identify candidate genes. The external validation dataset further tested the expression degree and diagnostic value of candidate biomarkers. To assess the validity of the diagnosis, we determined the receiver operating characteristic (ROC) curve. A convolution tool was employed to evaluate the composition of immune cells by CIBERSORT, and we performed correlation analyses on the basis of the training dataset. Twenty-seven DEGs were screened in the PD and control samples. Our results from the enrichment analysis showed a close association with inflammatory and immune-associated diseases. Both the LASSO and SVM algorithms screened eight and six characteristic genes. AGTR1, GBE1, TPBG, and HSPA6 are overlapping hub genes strongly related to PD. Our results of the area under the ROC (AUC), including AGTR1 (AUC = 0.933), GBE1 (AUC = 0.967), TPBG (AUC = 0.767), and HSPA6 (AUC = 0.633), suggested that these genes have good diagnostic value, and these genes were significantly associated with the degree of immune cell infiltration. AGTR1, GBE1, TPBG, and HSPA6 were identified as potential biomarkers in the diagnosis of PD and provide a novel viewpoint for further study on PD immune mechanism and therapy.

Transparent, Anti-Freezing and Highly Stretchable Solid-State Ionic Conductors

Stretchable ionic conductors show great promise for various applications including electronic skins, soft robotics, energy storage devices, actuators, and bio-integrated electronics. Solid-state ionic conductors do not suffer from the dehydration...

A sub-freshness monitoring chitosan/starch-based colorimetric film for improving color recognition accuracy via controlling the pH value of the film-forming solution

The demand for intelligent packaging in food sub-freshness monitoring is increasing. Herein, a pH and NH3 responsing colorimetric film (PS-CH-LCA) was fabricated based on potato starch (PS), chitosan (CH) and Lonicera caerulea L. anthocyanins (LCA) via controlling the pH value of the film-forming solution, and was applied to the real-time monitoring of shrimp freshness. The PS-CH-LCA pH 2.5 film exhibited the highest tensile strength (6.43 MPa), the lowest water solubility (33.11%) and the most sensitive color responsiveness. Morphological and structural results revealed that CH was attached to the surface of PS via hydrogen bond, and anthocyanins were well immobilized in the film-forming matrix. The sensitive color change and its high correlation with spoilage indices demonstrated the PS-CH-LCA pH 2.5 film well indicated fresh, sub-fresh, spoiled level of shrimp. The results solved the limitation of chitosan-based packaging films in undistinguishable colorimetric endpoints, providing a new strategy for indicating the sub-freshness of food packaging.

The influence of unexpected early termination of intravenous rt-PA treatment on clinical outcome in acute ischemic stroke patients

INTRODUCTION

This study aimed to explore the impact of unexpected early termination during intravenous thrombolysis on clinical prognosis in patients with acute ischemic stroke (AIS).

METHODS

Patients who received intravenous thrombolysis were divided into an early termination group and a normal treatment group. The causes of unexpected termination were analyzed, and the prognosis was compared between the groups.

RESULTS

The main causes of early termination of thrombolytic therapy included subjective wishes of family members (11.8%, 4) and persistently elevated blood pressure (14.7%, 5). The effective rate of thrombolytic therapy in the early termination group was significantly lower than that in the normal treatment group (P < 0.05). The rate of early neurological deterioration in the early termination group was significantly higher than that in the normal treatment group (P < 0.05). There was no significant difference in the incidence of symptomatic intracranial hemorrhage after thrombolysis between the two groups (P > 0.05). The average mRS score of the early termination group was significantly higher than that of the normal treatment group (P < 0.05). Multivariate analysis indicated that early termination of thrombolytic therapy and cumulative dosage of rt-PA before termination were the main factors affecting the 3-month prognosis.

CONCLUSION

Subjective wishes of family members and persistently elevated blood pressure may be the main causes of early termination of thrombolysis, and the 3-month prognosis of patients could be adversely affected by early termination of thrombolytic therapy and cumulative dosage of rt-PA. Certain measures, such as popularizing thrombolytic health education and optimizing blood pressure management before and during thrombolysis, may be helpful for the normal operation of intravenous thrombolysis.

Traditional uses, phytochemical constituents and pharmacological properties of Osmanthus fragrans: A review

ETHNOPHARMACOLOGICAL RELEVANCE

Osmanthus fragrans Lour., is a medicinal plant distributed widely in some Asian countries including Japan and Korea and southwestern China. It has been used traditionally for the treatment of weakened vision, halitosis, panting, asthma, cough, toothache, stomachache, diarrhea, rheumatism, physique pain and hepatitis.

AIM OF THE REVIEW

Recent advances in traditional uses, botanical characteristics, distribution, taxonomy, phytochemical constituents, biological effects as well as the toxicities of O. fragrans are comprehensively presented and critically evaluated, and the underlying mechanism associated with the bioactivities of extracts, essential oil and components from this plant is also well summarized. In order to provide comprehensive scientific basis for the medical application and help interested researchers discover food and medicinal natural products from O. fragrans.

MATERIALS AND METHODS

All information was systematically gathered from globally accepted scientific databases by Internet databases, including Elsevier, ScienceDirect, PubMed, Web of Science, Wiley, Springer, SciFinder, ACS Publications, CNKI, WanFang, Google Scholar, Baidu Scholar, The Plant List Database, and other literature sources (Ph.D. and MSc dissertations). All published contributions on O. fragrans different languages were included and cited. The chemical structures of all isolated compounds were drawn by using ChemBioDraw Ultra 14.0 software.

RESULTS

To date, more than 183 compounds were isolated and structurally identified from different plant parts of O. fragrans. Among them, ionone, ionol, flavonoids, polyphenols and iridoids, as the major bioactive substances, have been extensively studied and displayed the best bioactivity. Pharmacological studies demonstrated that O. fragrans and its active components had a wide range of biological activities, such as antioxidant, antitumor, anti-inflammatory, anti-hyperglycemic, anti-thrombotic, anti-melanogenesis, neuroprotective, and hepatoprotective activities, etc. CONCLUSION: O. fragrans, as a food and medicinal resource, has a good health care function and important edible and medicinal value, and thus has good prospects for utilization. However, many studies on biological activities were mainly based on extracts and the bioactive ingredients of this plant, and the mechanism responsible for these extracts and ingredients have not been well identified and there is a gap in research regarding clinical effect and safety. Therefore, the detail in vitro and in vivo studies on the mechanisms of action of the pure bioactive compounds and more clinical studies are encouraged to be conducted to ensure safety and effectiveness of the plant for human use.

Overabundance of Veillonella parvula promotes intestinal inflammation by activating macrophages via LPS-TLR4 pathway

Hirschsprung’s disease-associated enterocolitis (HAEC) is the most common complication of Hirschsprung’s disease (HSCR). The microbiome pattern of intestinal flora in HAEC patients was significantly abnormal compared to that in HSCR patients. The overabundance of V. parvula was detected in the gut of HAEC patients. To elucidate the pathological mechanisms of the overabundance of V. parvula, we established and analyzed inflammatory models induced by LPS or single-bacterial strain transplantation in vivo. The transplantation of V. parvula induced inflammatory response in the colon of mice. Besides, we found that LPS from V. parvula can significantly impair the barrier function of colonic epithelial cells and then activate macrophages which impaired pacemaker function of interstitial cells of Cajal (ICCs). It was thus a vicious cycle, where the macrophage-related inflammation caused by V. parvula via LPS-TLR4 pathway damaged the intestinal motility, which further aggravated the intestinal flora dysbiosis and promoted the development of HAEC. Itaconic acid could break the vicious cycle by inhibiting the activation of macrophages. It could be a potential therapeutic strategy for HAEC patients with intestinal flora dysbiosis.

Association between Cognitive Decline and Altered Cerebral Perfusion in Adults with Moyamoya Disease after Revascularization

INTRODUCTION

Certain studies have observed that patients with moyamoya disease (MMD) have cognitive decline after revascularization. Thus, this study analyzed the relationship between cognitive decline and altered cerebral perfusion after revascularization.

METHODS

Here, 313 adult patients with MMD underwent single unilateral revascularization. First, cognitive function was scored using a Mini-Mental Scale (MMSE) and Montreal cognitive function scale (MoCA) before and 3 months after the operation (superficial temporal artery-middle cerebral artery anastomosis with encephalo-myo-synangiosis). Then, computed tomography perfusion was performed before and 1 week after the operation to assess the cerebral perfusion.

RESULTS

Our data showed that cognitive function decreased in 55 cases (17.6%) after revascularization. Furthermore, the incidence of cerebral hyperperfusion (CHP) was significantly higher in the cognitive decline group (49/55) than in the cognitive nondecline group (89.1% vs. 5.4%, p < 0.001). Results also showed that although all 55 patients had postoperative cognitive decline, 47 experienced relative cerebral blood flow (CBF) decrease at a relatively distant area of the anastomosis compared with that before the operation, which was significantly higher than in patients without cognitive decline (85.5% vs. 1.94%, p < 0.001). In addition, 41 patients had a simultaneous occurrence of local CHP and paradoxical CBF decrease at a relatively distant anastomosis area, which indicated the incident of watershed shift (WS). As observed, WS occurred in 74.5% of patients with cognitive decline, significantly higher than in patients without cognitive decline (74.5% vs. 0%, p < 0.0001). Through multiple logistic regression analysis, WS was also observed to be a strong independent risk factor for predicting postoperative cognitive decline 3 months after revascularization (odds ratio 17.780, 95% confidence interval 1.668-18.564; p = 0.017).

CONCLUSION

Therefore, cognitive decline in patients with MMD after revascularization is related to WS, leading to an uneven distribution of CBF.

The Neuroprotective Effects of Paeoniflorin Against MPP+-induced Damage to Dopaminergic Neurons via the Akt/Nrf2/GPX4 Pathway

Paeoniflorin (PF), a water-soluble monoterpene glycoside extracted from the root of Paeonia lactiflora Pall, has been shown to exert neuroprotective effects against neurodegenerative diseases such as Parkinson's disease (PD). However, its underlying mechanisms remain unknown. Our results showed that at certain concentrations, PF alleviated 1-methyl-4-phenylpyridinium (MPP⁺)-induced morphological damage and inhibited neuronal ferroptosis. Moreover, our research indicated that the neuroprotective effect of PF could be partially blocked by ML385 (a nuclear factor erythroid-2-related factor 2 (Nrf2) inhibitor) and LY29400 (an Akt inhibitor). These findings suggest that PF protects against MPP⁺-induced neurotoxicity by preventing ferroptosis via activation of the Akt/Nrf2/Gpx4 pathway in vitro.

Lonicera caerulea (Haskap berries): a review of development traceability, functional value, product development status, future opportunities, and challenges

Lonicera caerulea is a honeysuckle plant with a long development history. It is defined as a "homology of medicine and food" fruit because it is rich in bioactive substances. By-products (such as pomace, leaves, stems, and flowers), which also have beneficial values, will be produced during processing. Nevertheless, the reuse of derivatives and the further development of new products of Lonicera caerulea are still a challenge. Firstly, this paper traced the development history of Lonicera caerulea and summarized its primary nutrients and bioactive substances, subsequently discussed the research progress and underlying molecular mechanisms of its functional properties, and introduced the application and potential of Lonicera caerulea in the fields of food, health products, cosmetics, medicine, and materials. Finally, this paper put forward the future research direction to promote the development of the Lonicera caerulea industry. To sum up, Lonicera caerulea, as a potential raw material, can be used to produce more functional products. Besides, more in-depth clinical trials are needed to clarify the specific molecular mechanism of the practical components of Lonicera caerulea and improve the rate of development and utilization.HighlightsThe original species of Lonicera caerulea subgroup had appeared on the earth as early as the end of the third century.Lonicera caerulea has been introduced into North America since the 18th century, but the introduction process has not ended until now.Lonicera caerulea widely exists in Eurasia and North America and it has excellent cold tolerance, early maturity and ornamental.The fruits, stems, leaves and flowers of Lonicera caerulea all have bioactive value, but the specific molecular mechanism and utilization need to be improved.Lonicera caerulea has been widely used in food, medicine, health products, cosmetics and materials, but there are still great challenges.

Hypoglycemic bioactivity of anthocyanins: A review on proposed targets and potential signaling pathways

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disease with complicated interrelationships responsible for initiating its pathogenesis. Novel strategies for the treatment of this devastating disease have attracted increasing attention worldwide. Anthocyanins are bioactive compounds that are widely distributed in the plant kingdom, and multiple studies have elucidated their beneficial role in preventing and managing T2DM. This review summarizes and comments on the hypoglycemic actions of anthocyanins from the perspective of molecular mechanisms and different target-related signaling pathways in vitro, in vivo, and clinical trials. Anthocyanins can ameliorate T2DM by functioning as carbohydrate digestive enzyme inhibitors, facilitating glucose transporter 4 (GLUT4) translocation, suppressing the effectiveness of dipeptidyl peptidase IV (DPP-IV), promoting glucagon-like peptide-1 (GLP-1) secretion, inhibiting protein tyrosine phosphatase 1B (PTP1B) overexpression, and interacting with sodium-glucose co-transporter (SGLT) to delay glucose absorption in various organs and tissues. In summary, anthocyanin is a promising and practical small molecule that can hyperglycemic symptoms and accompanying complications suffered by patients with diabetes. However, rational and potent doses for daily intake and clinical studies are required in the future.

Association of High Muscle Mass with Carotid Atherosclerosis: A Community-Based Population Cohort Study

OBJECTIVES

Although low muscle mass may make an under-appreciated contribution to increasing the risk of cardiovascular diseases, no prospective studies have explored the association between low muscle mass and carotid atherosclerosis. We investigated whether muscle mass was related to a higher carotid intima-media thickness (C-IMT) and carotid artery plaque in a community-based population.

METHODS

The study included 1,253 asymptomatic participants without known cardiovascular disease, who underwent carotid ultrasonography at baseline in 2013-2014 and received a re-examination in 2015-2016. The skeletal muscle mass index was estimated using a bioelectrical impedance analyzer. We assessed the relationship between the skeletal muscle mass index and the development of C-IMT and carotid plaque, both, using multivariate-adjusted logistic regression models.

RESULTS

During the follow up, 400 (51.0%) subjects with normal C-IMT at baseline developed elevated C-IMT and 215 (17.2%) subjects developed carotid plaque. The risk of elevated C-IMT occurrence linearly decreased with an increase in skeletal muscle mass index quintiles or its continuous data, after multivariate-adjustment in men and women, respectively (both P for trend < 0.05; both P < 0.05). Subgroup analyses showed that this association was BMI-dependent. Besides, there was an inverse association between a high skeletal muscle mass index and carotid artery plaque in women, but the association disappeared after multivariate adjustment. In men, the skeletal muscle mass index was not associated with the incidence of carotid plaque.

CONCLUSIONS

Skeletal muscle mass was inversely associated with the incidence of carotid atherosclerosis, suggesting muscle mass maintenance may play a role in modifying atherosclerosis.

Life Cycle Assessment on Environmental Sustainability of Food Processing

Food processing represents a critical part of the food supply chain that converts raw materials into safe and nutritious food products with high quality. However, the fast-growing food processing industry has imposed enormous burdens on the environment. Life cycle assessment (LCA) is widely used for evaluating the sustainability of food systems; nonetheless, current attention mainly concentrates on the agricultural production stage. This article reviews recent LCA studies on dairy, fruits and vegetables, and beverage products, with a particular emphasis on their processing stage. The environmental impacts of various foods are summarized, and the hotspots in their processing lines as well as potential remediation strategies are highlighted. Moreover, an outlook on the environmental performance of nonthermal processing, modified atmosphere packaging, and active packaging is provided, and future research directions are recommended. This review enables quantitative assessments and comparisons to be made by food manufacturers that are devoted to implementing sustainable processing technologies. Expected final online publication date for the Annual Review of Food Science and Technology, Volume 13 is March 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

The effects of tislelizumab plus chemotherapy as first-line treatment on health-related quality of life of patients with advanced squamous non-small cell lung cancer: Results from a phase 3 randomized clinical trial

BACKGROUND

This study assessed the effects of adding tislelizumab to first-line standard-of- care chemotherapy on the health-related quality of life (HRQoL) of patients with advanced squamous non-small cell lung cancer (sq-NSCLC).

PATIENTS AND METHODS

Patients in this open-label, multicenter, phase 3 RATIONALE 307 trial were randomized to one of the three arms: tislelizumab plus carboplatin and paclitaxel (Arm A), tislelizumab plus carboplatin and nab-paclitaxel (Arm B), or paclitaxel plus carboplatin (Arm C). HRQoL was measured using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30) and the EORTC Quality of Life Questionnaire Lung Cancer 13-item module (QLQ-LC13). Mean score change from baseline at Weeks 6 and 12 in the QLQ-C30's global health status/quality of life (GHS/QoL), fatigue, and physical functioning scores and QLQ-LC13 lung cancer specific subscales were examined. Time to deterioration was estimated for the GHS/QoL score.

RESULTS

A total of 355 sq-NSCLC patients received at least one dose of study drug and completed at least one HRQoL assessment. The GHS/QoL scores improved in Arms A and B relative to Arm C at Weeks 6 and 12. Arms A and B also experienced a reduction in most lung cancer-specific symptoms relative to Arm C. Time to deterioration of GHS/QoL was not reached by any of the three arms.

CONCLUSIONS

The addition of tislelizumab to platinum-based chemotherapy is associated with improvements in sq-NSCLC patients' HRQoL, especially in GHS/QoL and most importantly in lung cancer-specific symptoms including coughing, dyspnea, and hemoptysis.

Fabrication and characterization of gum arabic- and maltodextrin-based microcapsules containing polyunsaturated oils

BACKGROUND

Polyunsaturated oils have various health-promoting effects, however, they are highly prone to oxidation. Encapsulation using biopolymers is one of the most effective strategies to enhance oil stability. This research examined the potential of gum arabic and maltodextrin for microencapsulation of omega-3 rich oils, aiming to enhance encapsulation efficiency and stability of encapsulated oil.

RESULTS

We encapsulated fish and flaxseed oils by emulsification-spray drying. Spray-dried microcapsules were prepared by oil-in-water emulsions consisting of 10 wt% oil and 30 wt% biopolymer (gum arabic, maltodextrin, or their mixture). Results showed that both microcapsules were spherical in shape with surface shrinkage, and exhibited amorphous structures. Gum arabic-based microcapsules had higher encapsulation efficiency as well as better storage stability for both types of oil. Flaxseed oil microcapsules generally had higher oxidative stability regardless of the type of wall material.

CONCLUSIONS

Through a comprehensive characterization of the physical and chemical properties of the emulsions and resulting microcapsules, we proved gum arabic to be a more effective wall material for polyunsaturated oil microencapsulation, especially flaxseed oil. This study provides a promising approach to stabilize oils which are susceptible to deterioration, and facilitates their wider uses as food and nutraceutical products. © 2021 Society of Chemical Industry.