The Effects of Heavy Metal Pollution on Soil Nitrogen Transformation and Rice Volatile Organic Compounds under Different Water Management Practices

One of the most concerning global environmental issues is the pollution of agricultural soils by heavy metals (HMs), especially cadmium, which not only affects human health through Cd-containing foods but also impacts the quality of rice. The soil's nitrification and denitrification processes, coupled with the release of volatile organic compounds by plants, raise substantial concerns. In this review, we summarize the recent literature related to the deleterious effects of Cd on both soil processes related to the N cycle and rice quality, particularly aroma, in different water management practices. Under both continuous flooding (CF) and alternate wetting and drying (AWD) conditions, cadmium has been observed to reduce both the nitrification and denitrification processes. The adverse effects are more pronounced in alternate wetting and drying (AWD) as compared to continuous flooding (CF). Similarly, the alteration in rice aroma is more significant in AWD than in CF. The precise modulation of volatile organic compounds (VOCs) by Cd remains unclear based on the available literature. Nevertheless, HM accumulation is higher in AWD conditions compared to CF, leading to a detrimental impact on volatile organic compounds (VOCs). The literature concludes that AWD practices should be avoided in Cd-contaminated fields to decrease accumulation and maintain the quality of the rice. In the future, rhizospheric engineering and plant biotechnology can be used to decrease the transport of HMs from the soil to the plant's edible parts.

scCancer2: data-driven in-depth annotations of the tumor microenvironment at single-level resolution

SUMMARY

Single-cell RNA-seq (scRNA-seq) is a powerful technique for decoding the complex cellular compositions in the tumor microenvironment (TME). As previous studies have defined many meaningful cell subtypes in several tumor types, there is a great need to computationally transfer these labels to new datasets. Also, different studies used different approaches or criteria to define the cell subtypes for the same major cell lineages. The relationships between the cell subtypes defined in different studies should be carefully evaluated. In this updated package scCancer2, designed for integrative tumor scRNA-seq data analysis, we developed a supervised machine learning framework to annotate TME cells with annotated cell subtypes from 15 scRNA-seq datasets with 594 samples in total. Based on the trained classifiers, we quantitatively constructed the similarity maps between the cell subtypes defined in different references by testing on all the 15 datasets. Secondly, to improve the identification of malignant cells, we designed a classifier by integrating large-scale pan-cancer TCGA bulk gene expression datasets and scRNA-seq datasets (10 cancer types, 175 samples, 663 857 cells). This classifier shows robust performances when no internal confidential reference cells are available. Thirdly, scCancer2 integrated a module to process the spatial transcriptomic data and analyze the spatial features of TME.

AVAILABILITY AND IMPLEMENTATION

The package and user documentation are available at http://lifeome.net/software/sccancer2/ and https://doi.org/10.5281/zenodo.10477296.

The global burden of lymphoma: estimates from the Global Burden of Disease 2019 study

OBJECTIVES

The aim of this study was to describe the global trends in the burden of lymphoma from 1990 to 2019.

STUDY DESIGN

The data used in this study were from the Global Burden of Disease 2019 study.

METHODS

This study described the age-standardised rates of incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) of lymphoma (non-Hodgkin and Hodgkin's lymphoma, NHL and HL, respectively) annually from 1990 to 2019, stratified by sociodemographic index (SDI) and 21 world regions. The estimated annual percentage changes in these indexes were calculated.

RESULTS

In 2019, the age-standardised rates of HL per 100,000 population were lower than those of NHL in terms of incidence (1.1 vs 6.7 per 100,000 person-years, respectively) and prevalence (0.3 vs 5.7 per 100,000 person-years, respectively) but not mortality (21.6 vs 3.2 per 100,000 person-years, respectively). From 1999 to 2019, the global incidence of HL decreased and the incidence of NHL increased, and the prevalence of both HL and NHL increased, but the mortality rates decreased. When stratified by SDI, the incidence of HL decreased in all but middle-SDI regions, the mortality rate of HL decreased in all regions, and both the incidence and mortality rate of NHL increased in all but high-SDI regions. The prevalence of HL and NHL increased in all SDI regions, especially in middle-SDI regions. YLLs and DALYs of HL in all SDI regions and those of NHL in high-SDI regions decreased. YLDs slightly increased in middle- to high-SDI regions.

CONCLUSIONS

Lymphoma remains a major public health issue, and better prevention, precise identification, and promising treatments are vitally important.

Simulating Synaptic Behaviors through Frequency Modulation in a Capacitor-Memristor Circuit

Memristors, known for their adjustable and non-volatile resistance, offer a promising avenue for emulating synapses. However, achieving pulse frequency-dependent synaptic plasticity in memristors or memristive systems necessitates further exploration. In this study, we present a novel approach to modulate the conductance of a memristor in a capacitor-memristor circuit by finely tuning the frequency of input pulses. Our experimental results demonstrate that these phenomena align with the long-term depression (LTD) and long-term potentiation (LTP) observed in synapses, which are induced by the frequency of action potentials. Additionally, we successfully implement a Hebbian-like learning mechanism in a simple circuit that connects a pair of memristors to a capacitor, resulting in observed associative memory formation and forgetting processes. Our findings highlight the potential of capacitor-memristor circuits in faithfully replicating the frequency-dependent behavior of synapses, thereby offering a valuable contribution to the development of brain-inspired neural networks.

Deliberate foreign body ingestion in patients with underlying mental illness: A retrospective multicentre study

OBJECTIVE

Deliberate foreign body ingestion (DFBI) is characterised by recurrent presentations among patients with mental health conditions, intellectual disabilities and in prisoners. We aimed to profile the characteristics and evaluate the care of such patients in this study.

METHODS

Adult patients with an endoscopic record of attempted foreign body retrieval between January 2013 and September 2020 were identified at three Australian hospitals. Those with a documented mental health diagnosis were included and their standard medical records reviewed. Presentation history, demographics, comorbidities and endoscopic findings were recorded and described.

RESULTS

A total of 166 admissions were accounted for by 35 patients, 2/3 of which had borderline personality disorder (BPD). Repetitive presentations occurred in more than half of the cohort. There was an increased trend of hospital admissions throughout the years. At least half of the cohort had a documented mental health review during their admission. An average of 3.3 (2.9) foreign bodies were ingested per single episode. Endoscopic intervention was performed in 76.5% of incidents. The combined Length of stay for all patients was 680 days.

CONCLUSION

Deliberate foreign body ingestion in mental health patients is a common, recurring and challenging problem that is increasing in frequency and requires collaborative research to further guide holistic management.

Pre-Configured Error Pattern Ordered Statistics Decoding for CRC-Polar Codes

In this paper, we propose a pre-configured error pattern ordered statistics decoding (PEPOSD) algorithm and discuss its application to short cyclic redundancy check (CRC)-polar codes. Unlike the traditional OSD that changes the most reliable independent symbols, we regard the decoding process as testing the error patterns, like guessing random additive noise decoding (GRAND). Also, the pre-configurator referred from ordered reliability bits (ORB) GRAND can better control the range and testing order of EPs. An offline-online structure can accelerate the decoding process. Additionally, we also introduce two orders to optimize the search order for testing EPs. Compared with CRC-aided OSD and list decoding, PEPOSD can achieve a better trade-off between accuracy and complexity.

Biological functions of endophytic bacteria in Robinia pseudoacacia 'Hongsen'

Introduction

Endophytes and their host plants have co-evolved for a very long time. This relationship has led to the general recognition of endophytes as a particular class of microbial resources. R. pseudoacacia 'Hongsen' is drought- and barren-resistant species that can be grown in both the north and south of China, efficiently addresses the ecological issues caused by China's 'southern eucalyptus and northern poplar. Up to date, cultured-dependent studies are available for the R. pseudoacacia nitrogen-fixing and other endophytes. Therefore, the present research studied the R. pseudoacacia 'Hongsen,' microbiome in detail by high-throughput sequencing and culture dependant.

Methods

This study examined microbial species and functional diversity in Robinia pseudoacacia 'Hongsen' using culture-dependent (isolation) and culture-independent techniques.

Results

A total of 210 isolates were isolated from R. pseudoacacia 'Hongsen.' These isolates were clustered into 16 groups by the In Situ PCR (IS-PCR) fingerprinting patterns. 16S rRNA gene sequence analysis of the representative strain of each group revealed that these groups belonged to 16 species of 8 genera, demonstrating the diversity of endophytes in R. pseudoacacia 'Hongsen'. 'Bacillus is the most prevalent genus among all the endophytic bacteria. High-throughput sequencing of endophytic bacteria from R. pseudoacacia 'Hongsen' of the plant and the rhizosphere soil bacteria showed that the bacterial populations of soil near the root, leaf, and rhizosphere differed significantly. The microbial abundance decreased in the endophytes as compared to the rhizosphere. We observed a similar community structure of roots and leaves. With and without root nodules, Mesorhizobium sp. was significantly different in R. pseudoacacia 'Hongsen' plant.

Discussion

It was predicted that R. pseudoacacia 'Hongsen' plant endophytic bacteria would play a significant role in the metabolic process, such as carbohydrate metabolism, amino acid metabolism, membrane transport, and energy metabolism.

MedOptNet: Meta-Learning Framework for Few-shot Medical Image Classification

In the medical research domain, limited data and high annotation costs have made efficient classification under few-shot conditions a popular research area. This paper proposes a meta-learning framework, termed MedOptNet, for few-shot medical image classification. The framework enables the use of various high-performance convex optimization models as classifiers, such as multi-class kernel support vector machines, ridge regression, and other models. End-to-end training is then implemented using dual problems and differentiation in the paper. Additionally, various regularization techniques are employed to enhance the model's generalization capabilities. Experiments on the BreakHis, ISIC2018, and Pap smear medical few-shot datasets demonstrate that the MedOptNet framework outperforms benchmark models. Moreover, the model training time is also compared to prove its effectiveness in the paper, and an ablation study is conducted to validate the effectiveness of each module.

Sex Specific Global Burden of Osteoporosis in 204 Countries and Territories, from 1990 to 2030: An Age-Period-Cohort Modeling Study

BACKGROUND

Osteoporosis is a highly prevalent disease with distinct sex pattern. We aimed to estimate the sex specific incidence, prevalence, and disability-adjusted life (DALYs) years of osteoporosis between 1990 and 2019, with additional predictions from 2020 to 2034.

METHODS

We collected osteoporosis disease burden data from the Global Burden of Disease study covering the years 1990 through 2019 in 204 countries and territories. The data included information on the number of incident cases of osteoporosis, DALYs, age-standardized incidence rates (ASIR), age-standardized prevalence rates (ASPR) and age-standardized DALYs rates. Additionally, we performed an age-period-cohort analysis to forecast the burden of osteoporosis.

RESULTS

The global number of incidence cases of osteoporosis, in 2019, reached 41.5 million cases. From 1990 to 2019, the low-middle socio-demographic index (SDI) region had the highest estimated annual percentage change in the world. Compared to males, female's ASIR and ASPR were all about 1.5 times higher than males for the same years in the same SDI regions. The projected global total number of incidence cases for osteoporosis between 2030 and 2034 is estimated to reach 263.2 million (154.4 million for females and 108.8 for males). Additionally, the burden in terms of DALYs is predicted to be 128.7 million (with 78.4 million for females and 50.3 million for males).

CONCLUSION

The global burden of osteoporosis is still increasing, mainly observed in high SDI countries. Females bear a burden 1.5 times higher than males in terms of incidence and DALYs. Steps should be taken to reduce the osteoporosis burden, especially in high SDI countries.

Watchman device migration and embolization: a report from the NCDR LAAO registry

Background

Incomplete anchoring of the Watchman left atrial appendage closure (LAAO) device can result in substantial device migration or device embolization requiring percutaneous or surgical retrieval.

Purpose

To report rates and characteristics of in-hospital and post-discharge Watchman device migration and embolization events in the United States.

Methods

We performed a retrospective analysis of Watchman procedures (January 2016 through March 2021) reported to the National Cardiovascular Data Registry LAAO Registry. We excluded patients with prior LAAO interventions, no device released, and missing device information. In-hospital events were assessed among all patients and post-discharge events were assessed among patients with 45-day follow-up.

Results

Of 120,278 Watchman procedures, device migration or embolization occurred in 0.07% of patients (n=84) during the index hospitalization and surgery was performed in 39 patients. The in-hospital mortality rate was 14% among patients with device migration or embolization and 20.5% among patients who underwent surgery. In-hospital migration or embolization was more common: at hospitals with a lower median annual procedure volume (24 vs. 41 procedures, p<0.0001), with first-generation Watchman versus next-generation Watchman FLX devices (0.08% vs. 0.04%, p=0.0048), with larger LAA ostia (median 23 mm vs. 21 mm, p=0.004), and with a smaller difference between device and LAA ostial size (median difference 4 mm vs. 5 mm, p=0.04). There were no differences by age, sex, hospital type, hospital size, or teaching versus non-teaching status. Of 98,147 patients with 45-day follow-up, device migration or embolization after discharge occurred in 0.06% (n=54) patients and cardiac surgery was performed in 7.4% (n=4) of cases. The 45-day mortality rate was 3.7% (n=2) among patients with post-discharge device migration or embolization. Post-discharge migration or embolization was more common among men (79.7% of events but 58.9% of all procedures, p=0.0019), taller patients (177.9 cm vs. 172 cm, p=0.0005), and those with greater body mass (99.9 kg vs. 85.5 kg, p=0.0055); in contrast to in-hospital events, there were no differences in hospital volume, device characteristics, or LAA characteristics.

Conclusions

Watchman device migration or embolization is rare but associated with high mortality (Figure 1) and frequently requires surgical retrieval. A substantial proportion of all device migration or embolization cases occur after discharge and different patient and procedure characteristics are associated with in-hospital versus post-discharge cases. Given the morbidity and mortality associated with device migration or embolization, risk mitigation strategies and on-site cardiac surgical back-up are of paramount importance.

Funding Acknowledgement

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Institutes of Health

Revealing the promoting effect of multiple Mn valences on the catalytic activity of CeO2 nanorods toward soot oxidation

Mn-modified CeO₂ nanomaterials have attracted extensive attention as efficient and promising catalysts for soot combustion due to their low cost and high catalytic activity. However, a detailed mechanism of how Mn promotes soot oxidation over CeO₂ is still not clearly elucidated, which is crucial to further optimize the catalyst for achieving its practical applications. We here report a Mn-doped CeO₂ catalyst with tunable surface Mn chemical valence states to study the Mn-promoting mechanism for improving CeO₂ catalyst activity in soot oxidation. Experimental results show that Mn-doped CeO₂ nanorods with surface Mn chemical valence states being optimized (Mn_0.19Ce_0.81O₂) can lower the eliminating temperature of soot to 410 °C (T₉₀) when in a loose contact and exhibit a strong resistance towards water molecules. The catalytic performances of Mn_0.19Ce_0.81O₂ nanorods are comparable with those of other reported oxide catalysts both in the mimetic realistic and ideal reaction environments. Detailed characterization and theoretical calculation results demonstrate that balanced multiple Mn valences can dramatically enhance the catalysts' redox properties and their ability to activate O₂ molecules, as well as improve the dynamic contact efficiency during the oxidation, which synergistically result in superior catalytic performances. This work might provide insight for the future design and preparation of catalysts to efficiently eliminate soot particles.

Ensemble learning-based IDS for sensors telemetry data in IoT networks

The Internet of Things (IoT) is a paradigm that connects a range of physical smart devices to provide ubiquitous services to individuals and automate their daily tasks. IoT devices collect data from the surrounding environment and communicate with other devices using different communication protocols such as CoAP, MQTT, DDS, etc. Study shows that these protocols are vulnerable to attack and prove a significant threat to IoT telemetry data. Within a network, IoT devices are interdependent, and the behaviour of one device depends on the data coming from another device. An intruder exploits vulnerabilities of a device's interdependent feature and can alter the telemetry data to indirectly control the behaviour of other dependent devices in a network. Therefore, securing IoT devices have become a significant concern in IoT networks. The research community often proposes intrusion Detection Systems (IDS) using different techniques. One of the most adopted techniques is machine learning (ML) based intrusion detection. This study suggests a stacking-based ensemble model makes IoT devices more intelligent for detecting unusual behaviour in IoT networks. The TON-IoT (2020) dataset is used to assess the effectiveness of the proposed model. The proposed model achieves significant improvements in accuracy and other evaluation measures in binary and multi-class classification scenarios for most of the sensors compared to traditional ML algorithms and other ensemble techniques.

P-329 Endometrioma impairs oocyte development by extensive premature activation of primordial follicles in an experimental endometrioma mouse model

Study question

What are the pathological mechanisms of endometrioma-associated poor ovarian function?

Summary answer

Endometrioma prematurely activated primordial follicles and subsequently impaired ovarian functions through disrupting folliculogenesis and deteriorating oocyte quality.

What is known already

Endometrioma is the most common subtype of endometriosis, of which the endometriotic lesions implant in the ovary. Women with endometrioma are usually coupled with disrupted folliculogenesis, hampered ovulation, impaired oocyte quality and undesired infertility, presenting with reduced ovarian reserve, low oocyte retrieval rates and poor fertility outcomes. However the underlying mechanisms of the disrupted folliculogenesis, hampered ovulation and impaired oocyte quality in endometrioma-associated infertility are still unclear.

Study design, size, duration

An experimental mouse model of endometrioma (OMA) was established to study the effects of endometriosis in ovary on the development and functions of follicles. Four to eight mice were included in experimental and sham control groups each. Ovaries were collected 4 weeks after transplantation of endometrial fragments. Follicle counts and specific developmental markers were used to evaluate the development and functions of follicles. Oocyte quality was studied by meiotic competence, cortical distributions and ATP synthesis.

Participants/materials, setting, methods

Minced endometrial tissues from donor mice were inserted into ovarian bursa in recipient mice. Ovarian follicles in different stages were examined and counted manually with Periodic acid-Schiff staining. Protein expressions of FOXO3, AMH and FSHR were detected by immunohistochemistry to characterise the developing primordial, primary/secondary and antral follicles, respectively. Oocytes were collected from oviduct after superovulation and stained with a-tubulin, LCA-FITC to assess maturity.

Main results and the role of chance

Successful establishment of endometriotic lesions in ovarian tissues was confirmed morphologically and histologically with a success rate of 83.33% in recipient mice. In the OMA ovaries, absolute counts of the follicles in each developmental stage showed significant reduction when compared with sham controls. Percentage of primordial follicles was significantly reduced, but percentage of advanced-staged follicles was significantly increased. Expression of FOXO3 in primordial follicles, AMH in developing follicles (primary, secondary) and FSHR in antral follicles were all significantly decreased in OMA group. Oocytes isolated from OMA ovaries had lower number and size than controls. Large proportion of the oocytes had significantly higher abnormal spindle rates, indicating mitotic disruption. Moreover, a large proportion of the oocytes also had impaired cortical granule migration, indicating affected organelle organization.

Limitations, reasons for caution

Studies based on this animal model may not reflect the exact situation in human. Moreover, success rate of the OMA model cannot reach 100%. Other factors contributing to the endometrioma-associated infertility still undetermined in the OMA models.

Wider implications of the findings

The results demonstrated that endometrioma remarkably deteriorated follicular development, and subsequently impaired oocyte quality by premature activation primordial follicles. The underlying deteriorating effects and mechanism might help to develop novel therapeutic targets to improve fertility outcomes in women with endometrioma.

Trial registration number

N/A

Menopausal hormone therapy: what are the problems in the perception of Chinese physicians?

OBJECTIVE

This study aimed to investigate Chinese physicians' perception and attitudes toward menopausal hormone therapy (MHT).

METHODS

This nationwide online survey was conducted in China. Physicians registered in the WeChat groups of the Gynecological Endocrinology Committee of China's Maternal and Child Health Care Association received a message invitation to complete this anonymous online survey from April 2020 to July 2020. Physicians' knowledge of and attitudes toward MHT were surveyed.

RESULTS

In total, 4672 questionnaires were submitted; only completed questionnaires could be submitted. The message was sent to 6021 doctors, so the response rate was 77.6%. Overall, 77.9-92.9% of physicians knew the common indications and contraindications to MHT. Additionally, 90.6%, 85.4%, 80.7% and 37.5% of physicians thought that MHT would increase the risk of venous thrombosis, breast cancer, endometrial cancer and weight gain, respectively. In total, 58.1% of the physicians mistakenly believed that a sex hormone test was one of the necessary examinations to reassess MHT prescription during follow-up visits. We found that 68.5% of physicians would consider using MHT themselves or recommend MHT to their partners in the future, and 11.4% were currently using MHT.

CONCLUSIONS

Most Chinese physicians have basic knowledge of MHT. Their misunderstandings about MHT mainly centered on the risks of endometrial cancer, weight gain and the necessary examinations during follow-up visits. These misunderstandings need to be clarified in future professional training programs.

Medication Therapy of High-Dose Methotrexate: An Evidence-Based Practice Guideline of the Division of Therapeutic Drug Monitoring, Chinese Pharmacological Society

OBJECTIVES

A lot of medication risks related to high-dose methotrexate (HDMTX) therapy still remain to be identified and standardized. This study aims to establish an evidence-based practice guideline for individualized medication of HDMTX.

METHODS

The practice guideline was launched by the Division of Therapeutic Drug Monitoring, Chinese Pharmacological Society. The guideline was developed following the WHO handbook for guideline development and the methodology of evidence-based medicine (EBM). The guideline was initially registered in the International Practice Guidelines Registry Platform (IPGRP-2017CN021). Systematic reviews were conducted to synthesis available evidence. A multicenter cross-sectional study was conducted by questionnaires to evaluate patients' perception and willingness on individualized medication of HDMTX. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to rate the quality of evidence and to grade the strength of recommendations.

RESULTS

Multidisciplinary working groups were included in this guideline, including clinicians, pharmacists, methodologists, pharmacologists and pharmacoeconomic specialists. A total of 124 patients were involved to integrate patient values and preferences. Finally, the guideline presents 28 recommendations, regarding evaluation prior to administration (renal function, liver function, pleural effusion, comedications, genetic testing), pre-treatment and routine dosing regimen, therapeutic drug monitoring (necessity, method, timing, target concentration), leucovorin rescue (initial timing, dosage regimen and optimization), management of toxicities. Of them, 12 are strong recommendations.

CONCLUSIONS

We developed an evidence-based practice guideline with respect to HDMTX medication using a rigorous and multidisciplinary approach. This guideline provides comprehensive and practical recommendations involving the whole process of HDMTX administration to health care providers.

Bioanalytical strategies in drug discovery and development

A reliable, rapid, and effective bioanalytical method is essential for the determination of the pharmacokinetic, pharmacodynamic, and toxicokinetic parameters that inform the safety and efficacy profile of investigational drugs. The overall goal of bioanalytical method development is to elucidate the procedure and operating conditions under which a method can sufficiently extract, qualify, and/or quantify the analyte(s) of interest and/or their metabolites for the intended purpose. Given the difference in the physicochemical properties of small and large molecule drugs, different strategies need to be adopted for the development of an effective and efficient bioanalytical method. Herein, we provide an overview of different sample preparation strategies, analytical platforms, as well as procedures for achieving high throughput for bioanalysis of small and large molecule drugs.

P–316 A rat model of endometrioma to study endometriosis-related infertility

Study question

Underlying mechanisms and specific treatment for endometriosis-related infertility are still unclear and lacking. Is there any animal model suitable for the study?

Summary answer

Endometium ligation to ovary fat pad in rats is a more appropriate and successful but less detrimental model of endometrioma for infertility pathology and outcomes.

What is known already

Nonhuman primates (NHP) have been the most representative animal model for endometriosis since they menstruate in a cyclic pattern and develop endometriosis spontaneously as in human. However, the incidence of spontaneous endometriosis in NHP is low and due to ethical concerns and high cost, the application of NHP for endometriosis study is restricted. Rodents (i.e. rats, mice, rabbits) have been used to analyze the pathophysiology of endometriosis. Because rodents do not develop endometriosis spontaneously, it has to be induced surgically. Ovarian endometriosis is the most common type, but previous experimental models were mostly either subcutaneous, peritoneal wall or mesenteric endometriosis.

Study design, size, duration

An animal study to compare different methods of endometrium transplantation to the ovary as potential animal model of endometrioma to study the endometriosis-related infertility. Compared with NHP and other rodents, rats were chosen due to easy access, low cost, good ovary size, short estrus and reproductive cycle and similar endocrine pattern to human beings. For each transplantation method, at least 5 animals were included and followed up in different time points for comparisons.

Participants/materials, setting, methods

To establish ovarian endometriosis or endometrioma model, uterine tissues were collected from donor rats and then transplanted to recipient rats by either adhesion to ovary, ligation to ovary fat pad, or injection underneath tunica albuginea. Vasculature and histology of engrafts, follicle count and morphology of ovary, receptivity markers of endometrium, immune response and inflammatory cytokines of peritoneal cavity and hormonal changes were assessed after 4 days of transplantation. Implantation rates after conception will be examined.

Main results and the role of chance

Compared with other transplantation methods, only ligation of endometrium fragments to ovary fat pad resulted in endometrioma-like lesion in the ovaries. Compare with sham control ovaries, formation of new vessels from surrounding ovarian vessels to the endometriotic engraft assessed by Cellvizio LAB in vivo imaging was identified, indicating active angiogenesis. Morphology and histology of endometriotic cyst were confirmed in the lesion by H&E staining, suggesting functional endometrium. Stroma markers CD140b, CD106 lkand epithelium markers keratin 17/19 and EpCam were found in the ovary cortex, implying integration of endometrium tissue to the ovarian tissues. Decreased AMH expression and antral follicle count in the ovaries suggested defective follicle development. Reduced receptivity markers HOXA10, LIF and ανβ3 integrin expression in uterine endometrium and implantation rate after nature mating or embryo transfer indicated potential impaired endometrial receptivity. Peripheral and peritoneal levels of COX2 and IL–8 were elevated, suggesting inflammatory response. However, estrogen and progesterone levels were not significant different from baseline and other transplantation methods.

Limitations, reasons for caution

This was an animal model, it might not totally reflect the exact pathological changes of endometrioma in human. Current method was a single and short-term transplantation model, monthly endometrial cells engraftment and slow growing lesions without sufficient estrogen supply might limit the establishment of endometrium-like lesions. Further testings are needed.

Wider implications of the findings: Establishment of animal models for endometrioma is vital important to investigate the pathophysiology, underlying mechanism and potential therapy targets for endometriosis-related infertility. Currently such model is still lacking. An appropriate, adequate and effective but less detrimental model of endometrioma can accelerate the scientific research and clinical application in near future.

Trial registration number

N/A

Effects of Pharmacist-Led Clinical Pathway/Order Sets on Cancer Patients: A Systematic Review

Background: Pharmacist-led clinical pathways/order sets (PLCOs) were first applied for designated diseases and surgical operations, such as cancer. They were not used in pharmacotherapy until recently. After screening a large number of publications, we found that PLCOs were rarely accessible.

Objective: To evaluate the effects and the changes of relevant medical outcomes of PLCOs.

Methods: Articles from PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang database, and China Biology Medicine disc (CBM) were systematically retrieved. Clinical research comparing cancer patients’ clinical effects with or without clinical pathway/order sets was performed. Two reviewers performed quality assessment, and the data were abstracted independently. A narrative synthesis of the extracted data was performed due to heterogeneity.

Results: Nine studies were identified, including six uncontrolled before–after studies and three case-series studies. The scopes of PLCOs of included research can be divided into two types, one focusing on chemotherapy agents and the other on the managements of chemotherapy-induced complications. The PLCOs shortened hospital length of stay, decreased initial antibiotic time intervals in patients with febrile neutropenia, reduced medication error incidence, and increased physicians’ adherence rate to clinical pathway/order sets. Moreover, three articles included economic effects showing positive savings on medication costs through PLCOs.

Conclusion: PLCOs can have beneficial effects on medication effectiveness, safety, and economic outcomes. Nevertheless, clinical pathway/order sets need to be further optimized and expanded to other clinical areas.

[Amiodarone promotes heat-induced apoptosis, inflammation and oxidative stress in mouse HL1 atrial myocytes]

OBJECTIVE

To investigate the injury types of atrial myocytes induced by heat exposure and the effect of amiodarone on heat-induced injuries in atrial myocytes.

OBJECTIVE

The optimal temperature for heat exposure and optimal concentration of amiodarone were determined by measuring the cell viability exposed to different temperatures and different concentrations of amiodarone. Heat exposure of HL1 atrial myocytes was conducted using a water bath, and the effect of amiodarone on cell viability was assessed with MTS method; cell apoptosis was detected using flow cytometry, and the levels of IL-1β, IL-6, TNF-α, SOD and MDA were detected with enzyme-linked immunosorbent assay (ELISA).

OBJECTIVE

Compared with the blank control cells, the cells exposed to a temperature of 52 ℃ showed a significantly decreased survival rate and a lowered SOD activity (P < 0.001) with increased IL-1β and MDA levels (P < 0.01) and markedly increased apoptosis rate and IL-6 level (P < 0.001). Compared with the heat exposure group, amiodarone resulted in significantly decreased survival rate of the atrial myocytes (P < 0.01), obviously decreased SOD activity (P < 0.05), and increased cell apoptosis rate (P < 0.05) and IL-1β, IL-6, MDA and TNF-α levels (P < 0.01 or 0.001).

OBJECTIVE

Heat exposure induces apoptosis, inflammation and oxidative stress in mouse HL1 atrial myocytes, and amiodarone can enhance the effects of heat exposure to aggravate the cell injuries.

Peripheral blood T-cell receptor repertoire as a predictor of clinical outcomes in gastrointestinal cancer patients treated with PD-1 inhibitor

BACKGROUND

Identifying valid biomarkers for patient selection impressively promotes the success of anti-PD-1 therapy. However, the unmet need for biomarkers in gastrointestinal (GI) cancers remains significant. We aimed to explore the predictive value of the circulating T-cell receptor (TCR) repertoire for clinical outcomes in GI cancers who received anti-PD-1 therapy.

METHODS

137 pre- and 79 post-treated peripheral blood samples were included. The TCR repertoire was evaluated by sequencing of complementarity-determining region 3 (CDR3) in the TRB gene. The Shannon index was used to measure the diversity of the TCR repertoire, and Morisita's overlap index was used to determine TCR repertoire similarities between pre- and post-treated samples.

RESULTS

Among all enrolled patients, 76 received anti-PD-1 monotherapy and 61 received anti-PD-1 combination therapy. In the anti-PD-1 monotherapy cohort, patients with higher baseline TCR diversity exhibited a significantly higher disease control rate (77.8% vs. 47.2%; hazard ratio [HR] 3.92; 95% confidence interval [CI] 1.14-13.48; P = 0.030) and a longer progression-free survival (PFS) (median: 6.47 months vs. 2.77 months; HR 2.10; 95% CI 1.16-3.79; P = 0.014) and overall survival (OS) (median: NA vs. 8.97 months; HR 3.53; 95% CI 1.49-8.38; P = 0.004) than those with lower diversity. Moreover, patients with a higher TCR repertoire similarity still showed a superior PFS (4.43 months vs. 1.84 months; HR 13.98; 95% CI 4.37-44.68; P < 0.001) and OS (13.40 months vs. 6.12 months; HR 2.93; 95% CI 1.22-7.03; P = 0.016) even in the cohort with lower baseline diversity. However, neither biomarker showed predictive value in the anti-PD-1 combination therapy cohort. Interestingly, the combination of TCR diversity and PD-L1 expression can facilitate patient stratification in a pooled cohort.

CONCLUSION

The circulating TCR repertoire can serve as a predictor of clinical outcomes in anti-PD-1 therapy in GI cancers.

High-resolution MRI of the vessel wall helps to distinguish moyamoya disease from atherosclerotic moyamoya syndrome

AIM

To evaluate the value of high-resolution magnetic resonance imaging of the vessel wall (VWI) for differentiating moyamoya disease (MMD) from atherosclerotic moyamoya syndrome (AS-MMS).

MATERIALS AND METHODS

Twenty-one patients with MMD or AS-MMS were assessed retrospectively by two independent raters regarding and magnetic resonance angiography (MRA) stage grading score; collateral development in the lateral fissure and basal ganglia on MRA; and pattern of the thickening of the arterial wall; presence, degree, and pattern of enhancement; presence and distribution of deep tiny flow voids (DTFVs) and collateral development in the lateral fissure and basal ganglia on VWI. After univariate analysis between the two groups, logistic regression models based on imaging findings of MRA or VWI were implemented respectively, and receiver operating characteristic (ROC) curves were generated to compare the discriminatory power of the two imaging methods for diagnosis of MMD. Interrater agreement was analysed using an unweighted Cohen's κ or interclass correlation coefficient (ICC).

RESULTS

MMD manifested as more concentric thickening, more homogeneous enhancement, higher presence of DTFV, smaller outer-wall boundary area of stenosis or occlusion, and smaller remodelling index on VWI. After Bonferroni-Holm correction for multiple comparisons, for AS-MMS, collaterals in both the lateral fissure and basal ganglia were not usually present on either MRA or VWI. The diagnostic performance of the multivariate logistic regression model based on VWI with an accuracy of 87.1% for classification was higher than MRA. Interrater agreement was moderate or substantial for all the imaging findings.

CONCLUSIONS

VWI might be a useful and feasible method for differentiating MMD from AS-MMS and a prospective tool for guiding first-line treatment.

Spatial and temporal organization of jejunal microbiota in goats during animal development process

AIMS

This research aimed to investigate the temporal bacterial colonization relating to non-rumination, transition and rumination phases, together with the spatial organization of microbial community in the jejunal mucosa and digesta of goats.

METHODS AND RESULTS

This study explored the colonization programme of the jejunal microbiota by employing 16S rRNA amplicon sequencing. The colonization pattern of jejunal bacterial community exhibited an age- and gut region-dependent progression during animal development process. Approximately 268 bacterial signatures contributed to the discrimination between gut regions, with Lactobacillus, Ruminococcus, Eubacterium and Clostridium_sensu_stricto were enriched in the jejunal digesta, and Bacteroides and unclassified bacteria were enriched in the jejunal mucosa. Intriguingly, a shift from Lactobacillus to Butyrivibrio, Eubacterium and Ruminococcus after d 20 was observed for jejunal digesta. In mucosa, Bifidobacterium, Corynebacterium, Faecalibacterium and Roseburia increased with age (P < 0·05) while Arcobacter, Bacteroides and Porphyromonas peaked at d 10.

CONCLUSIONS

The jejunal bacterial community was settled after solid starter provision, which may mark the potential boundary of a timeframe for intervention in goats. The spatial heterogeneity highlighted the complicacy of ecological niches during manipulation of gut microbiota.

SIGNIFICANCE AND IMPACT OF THE STUDY

The present study extended the understanding of microbial programming and niche specific in the jejunum among different life stages and the basal cognition of persistent enhancement of nutrient utilization and decline of enteric diseases in ruminants.

[Clinical application of the gasless unilateral axillary approach in endoscopic thyroid surgery]

Objective: To investigate the efficacy, safety and advantages of gasless unilateral axillary approach (GUAA) in endoscopic thyroid surgery. Methods: A total of 334 patients who underwent the GUAA endoscopic thyroid surgery (GUAA group) or conventional open thyroid surgery (OS group) in the Department of Head and Neck Surgery of Zhejiang Cancer Hospital from January 2017 to June 2018 were retrospectively analyzed. There were 45 males and 289 females, aged from 12 to 72 years old, of whom 139 patients were assigned to GUAA group and 195 patients to OS group. Pathological results included papillary thyroid carcinoma (282 cases), nodular goiter (41 cases) and thyroid adenoma (11 cases). Surgical exploration development curve of GUAA group was drawn and was divided into two parts: the technical exploration stage and the technical stable stage. Surgical efficiency, incidences of complications, and incision satisfaction were compared between GUAA group in technical stable stage and OS group. SPSS 25.0 software was adopted for statistical analysis. Results: The mean age in GUAA group was younger than that in OS group, with a significant difference [(35.3±9.5) years vs. (48.1±10.6) years, t=11.31, P<0.01]. The cases in the endoscope group were divided into technical exploration stage for 51 cases and technical stable stage for 88 cases according to the exploration and development curve. In unilateral radical thyroidectomy and unilateral thyroid lobectomy, the mean operation time [(90.6±18.6) min and (93.5±22.0) min] and postoperative drainage volumes [(121.5±87.6) ml and (155.5±69.1) ml] of GUAA group in the stable stage were more than those of OS group [(61.6±15.6) min and (46.5±8.4) min] and [(93.2±42.3) ml and (78.9±48.7) ml]. The difference was statistically significant (t=12.28, 7.23, 3.35 and 3.05 respectively, all P<0.05), but there were no significant differences in surgical bleeding volumes between two groups [(12.7±6.8) ml vs. (13.5±7.7) ml, t=0.74, P>0.05 and (16.3±14.1) ml vs. (11.9±5.1) ml, t=1.05, P>0.05]. Compared with OS group, GUAA group had the lower incidence of anterior cervical discomfort during swallowing (2.3% vs. 29.2%, P<0.01) and the higher incision satisfaction score (1.1±0.5 vs. 2.8±0.7, t=21.12, P<0.01), however, GUAA group had the higher incidence of supraclavicular (or infraclavicular) numbness after surgery (5.7% vs. 0, P<0.01). And there was no significant difference in the incidences of temporary recurrent laryngeal nerve injury, bleeding, hematoma, infection, lymphatic leakage or chylous leakage after surgery between two groups (P>0.05). Conclusion: GUAA endoscopic thyroid surgery is a safe method with high cosmetic satisfaction.

Grape-seed polyphenols inhibit AAA in mice via regulation of macrophage polarization

AIM

Abdominal aortic aneurysm (AAA) is characterized by macrophage polarization, and at present, no drug therapy is available. Although grape-seed polyphenols (GSP) showed an anti-AAA effect, the role of GSP in the phenotype shift in macrophages remains unknown.

METHOD

The main phenolic compounds in GSP were determined by LC-MS. Male C57BL/6 mice were divided into four equal groups, namely sham group, CaPO4 group, CaPO4+GSP low-dose group, and CaPO4+GSP high-dose group. GSP was administered intragastrically after CaPO4 application. Molecular expressions were histologically evaluated and analyzed by various staining assays and FACS.

RESULTS

GSP administration inhibited CaPO4-induced AAA formation, which correlated with a decrease in macrophage infiltration and retainment of vascular smooth muscle layer as compared to those in the CaPO4 group. FACS assay showed that the GSP administration dose-dependently decreased the CD54 expression (low-dose group: 11.4 ± 2.1 % and high-dose group: 4.8 ± 1.4 % vs 23.2 ± 3.6 %; p < 0.05 and p < 0.01, respectively) and increased the CD206 expression of F4/80-positive cells in GSP-administered groups as compared with that in CaPO4-injured aortas in the CaPO4 group (low-dose group: 22.4 ± 3.3 % and high-dose group: 26.7 ± 4.2 % vs 8.1 ± 1.3 %; p < 0.05 and p < 0.01, respectively).

CONCLUSIONS

GSP could be a pharmacologically potent agent in the treatment of AAA (Tab. 1, Fig. 3,Ref. 20). Text in PDF www.elis.sk Keywords: grape-seed polyphenols, abdominal aortic aneurysm, macrophage, inflammatory, polarization.

[Predictive analysis of distant metastasis after primary treatment of papillary thyroid cancer in patients under 18 years old]

Objective: To investigate the distant metastasis after primary treatment of papillary thyroid cancer (PTC) in children and adolescents. Methods: A retrospective analysis of 180 cases (54 boys and 126 girls, with an age range of 6-18 years) with PTC treated at the Chinese Medical Academy Cancer Hospital and Zhejiang Cancer Hospital from January 1, 2001 to December 31, 2014 was performed. Patients' clinical and pathological data were collected. The follow-up results were statistically analyzed. The distant metastasis rate during the follow-up period was analyzed by the Kaplan-Meier method. Log-Rank test was used for univariate analysis and Cox regression model was established in multivariate analysis. Results: Twenty-four cases (13.3%) had distant metastases during following-up with a median of 92 months. The Log-Rank test showed that the younger age ≤15 years old (χ(2)=11.803, P=0.001), the larger tumor diameter >20 mm (χ(2)=5.776, P=0.016), multifocal (χ(2)=11.205, P=0.001), bilateral tumor distribution (χ(2)=19.804, P=0.001), invaded capsule (χ(2)=10.808, P=0.001), and bilateral lymph nodes metastasis (χ(2)=6.278, P=0.012) were risk factors for distant metastasis after initial treatment. The Cox regression analysis showed that age ≤15 years (hazard ratio [95% confidence interval]: 4.08[1.504-11.111], P=0.006) and bilateral tumor distribution (hazard ratio [95% confidence interval]: 4.77[1.903-11.966], P=0.001) were independent risk factors for distant metastasis after initial treatment. The risk factors for local recurrence and distant metastasis were similar, but the local recurrence could not be a significant predictor for distant metastasis. It was indicated that distant metastasis rate was lower in patients with total thyroidectomy in multifocal lesions groups (χ(2)=5.891, P=0.015). Conclusions: Age, tumor size, invaded capsule, bilateral lymph nodes metastasis, multifocal and bilateral lesions are factors for predicting distant metastasis after primary treatment of PTC in children and adolescents. Total thyroidectomy is recommended for patients with multifocal and bilateral lesions.

Exploring coupled images fusion based on joint tensor decomposition

Data fusion has always been a hot research topic in human-centric computing and extended with the development of artificial intelligence. Generally, the coupled data fusion algorithm usually utilizes the information from one data set to improve the estimation accuracy and explain related latent variables of other coupled datasets. This paper proposes several kinds of coupled images decomposition algorithms based on the coupled matrix and tensor factorization-optimization (CMTF-OPT) algorithm and the flexible coupling algorithm, which are termed the coupled images factorization-optimization (CIF-OPT) algorithm and the modified flexible coupling algorithm respectively. The theory and experiments show that the effect of the CIF-OPT algorithm is robust under the influence of different noises. Particularly, the CIF-OPT algorithm can accurately restore an image with missing some data elements. Moreover, the flexible coupling model has better estimation performance than a hard coupling. For high-dimensional images, this paper adopts the compressed data decomposition algorithm that not only works better than uncoupled ALS algorithm as the image noise level increases, but saves time and cost compared to the uncompressed algorithm.

Isolation and Characterization of the Novel Phages vB_VpS_BA3 and vB_VpS_CA8 for Lysing Vibrio parahaemolyticus

Accumulating evidence has indicated that the multiple drug resistant Vibrio parahaemolyticus may pose a serious threat to public health and economic concerns for humans globally. Here, two lytic bacteriophages, namely vB_VpS_BA3 and vB_VpS_CA8, were isolated from sewage collected in Guangzhou, China. Electron microscopy studies revealed both virions taxonomically belonged to the Siphoviridae family with icosahedral head and a long non-contractile tail. The double-stranded DNA genome of phage BA3 was composed of 58648 bp with a GC content of 46.30% while phage CA8 was 58480 bp with an average GC content of 46.42%. In total, 85 putative open reading frames (ORFs) were predicted in the phage BA3 genome while 84 were predicted in that of CA8. The ORFs were associated with phage structure, packing, host lysis, DNA metabolism, and additional functions. Furthermore, average nucleotide identity analysis, comparative genomic features and phylogenetic analysis revealed that BA3 and CA8 represented different isolates but novel members of the family, Siphoviridae. Regarding the host range of the 61 V. parahaemolyticus isolates, BA3 and CA8 had an infectivity of 8.2 and 36.1%, respectively. Furthermore, ∼100 plaque-forming units (pfu)/cell for phage BA3 and ∼180 pfu/cell for phage CA8 were determined to be the viral load under laboratory growth conditions. Accordingly, the phage-killing assay in vitro revealed that phage CA8 achieved approximately 3.65 log unit reductions. The present results indicate that CA8 is potentially applicable for biological control of multidrug resistant V. parahaemolyticus.

Expression and distribution of HIF-1α, HIF-2α, VEGF, VEGFR-2 and HIMF in the kidneys of Tibetan sheep, plain sheep and goat

BACKGROUND

The objective of this study was to detect the expression and distribution characteristics of five proteins (the hypoxia-inducible factor 1alpha [HIF-1a], HIF-2a, vascular endothelial growth factor [VEGF], VEGF-2 receptor [VEGFR-2] and hypoxia-induced mitogenic factor [HIMF]) in kidney of Tibetan sheep, plain sheep and goat. The results will provide the basic information for the comparative study of sheep breeds living at different altitudes.

MATERIALS AND METHODS

The kidney tissues were collected from healthy adult Tibetan sheep, plain sheep and goats and made into paraffin sections. Histological characteristics were assessed by haematoxylin and eosin staining. Expressions of HIF-1a, HIF-2a, VEGF, VEGFR-2 and HIMF proteins were measured by immunohistochemical staining.

RESULTS

Immunohistochemistry results showed that the positive expression signals of HIF-1a, HIF-2a, VEGF and VEGFR-2 were detected in epithelial cells of renal tubules and collecting tubules, renal corpuscles in the kidneys of the three sheep breeds. Positive expression signals of HIMF were detected in epithelial cells of proximal tubules and distal tubules in Tibetan sheep and epithelial cells of distal tubules in goat. Immunostaining intensity of HIF-1a, HIF-2a, VEGF and VEGFR-2 proteins in Tibetan sheep was significantly higher than that in both plain sheep and goat (p < 0.05). Immunostaining intensity of HIMF in Tibetan sheep was higher than goat (p < 0.05). Positive expression signals of HIMF were not detected in plain sheep.

CONCLUSIONS

The expression and distribution characteristics of HIF-1a, HIF-2a, VEGF, VEGFR-2 and HIMF in the studied kidney tissues suggested that these proteins may be related to the physiological regulation of Tibetan sheep kidney in hypoxia environment, and therefore might be important regulating proteins for Tibetan sheep to adapt to high altitude hypoxia environment.

Regularized calibrated estimation of propensity scores with model misspecification and high-dimensional data

Propensity scores are widely used with inverse probability weighting to estimate treatment effects in observational studies. We study calibrated estimation as an alternative to maximum likelihood estimation for fitting logistic propensity score models. We show that, with possible model misspecification, minimizing the expected calibration loss underlying the calibrated estimators involves reducing both the expected likelihood loss and a measure of relative errors between the limiting and true propensity scores, which governs the mean squared errors of inverse probability weighted estimators. Furthermore, we derive a regularized calibrated estimator by minimizing the calibration loss with a lasso penalty. We develop a Fisher scoring descent algorithm for computing the proposed estimator and provide a high-dimensional analysis of the resulting inverse probability weighted estimators, leveraging the control of relative errors of propensity scores for calibrated estimation. We present a simulation study and an empirical application to demonstrate the advantages of the proposed methods over maximum likelihood and its regularization. The methods are implemented in the R package RCAL.

Mobility Aware Duty Cycling Algorithm (MADCAL) A Dynamic Communication Threshold for Mobile Sink in Wireless Sensor Network

The hotspot issue in wireless sensor networks, with nodes nearest the sink node losing energy fastest and degrading network lifetime, is a well-referenced problem. Mobile sink nodes have been proposed as a solution to this. They do not completely remove the hotspot problem though, with nodes the sink passes most closely still expending more energy than others. This study proposes a lightweight algorithm, located in the media access control (MAC) layer of static nodes and utilising knowledge of predictable sink node mobility. This is in order to create a dynamic communication threshold between static nodes and the sink, within which static nodes awaken, lessening competition for sink communication between nodes. In utilising predictable mobility and factors already known to the static node, such as location and interference range, there is no need for energy-consuming messaging. Analysis and simulation results, tested on a lightweight implementation of a carrier-sense multiple-access-based MAC protocol, show a significant improvement in energy consumption in both controlled and random environments, with frame delivery improved to the point where sink speed is negated. This is when compared to the existing duty cycling approach.

Dynamic role of single-celled fungi in ruminal microbial ecology and activities

In ruminants, high fermentation capacity is necessary to develop more efficient ruminant production systems. Greater level of production depends on the ability of the microbial ecosystem to convert organic matter into precursors of milk and meat. This has led to increased interest by animal nutritionists, biochemists and microbiologists in evaluating different strategies to manipulate the rumen biota to improve animal performance, production efficiency and animal health. One of such strategies is the use of natural feed additives such as single-celled fungi yeast. The main objectives of using yeasts as natural additives in ruminant diets include; (i) to prevent rumen microflora disorders, (ii) to improve and sustain higher production of milk and meat, (iii) to reduce rumen acidosis and bloat which adversely affect animal health and performance, (iv) to decrease the risk of ruminant-associated human pathogens and (v) to reduce the excretion of nitrogenous-based compounds, carbon dioxide and methane. Yeast, a natural feed additive, has the potential to enhance feed degradation by increasing the concentration of volatile fatty acids during fermentation processes. In addition, microbial growth in the rumen is enhanced in the presence of yeast leading to the delivery of a greater amount of microbial protein to the duodenum and high nitrogen retention. Single-celled fungi yeast has demonstrated its ability to increase fibre digestibility and lower faecal output of organic matter due to improved digestion of organic matter, which subsequently improves animal productivity. Yeast also has the ability to alter the fermentation process in the rumen in a way that reduces methane formation. Furthermore, yeast inclusion in ruminant diets has been reported to decrease toxins absorption such as mycotoxins and promote epithelial cell integrity. This review article provides information on the impact of single-celled fungi yeast as a feed supplement on ruminal microbiota and its function to improve the health and productive longevity of ruminants.

Severe toxic effects of low-dose methotrexate treatment for placenta accreta in a patient with methylenetetrahydrofolate reductase mutations

WHAT IS KNOWN AND OBJECTIVE

Low-dose methotrexate (LDMTX) has been widely used for many decades in clinical settings, with good safety profiles compared with those of high-dose methotrexate. LDMTX is also used as one of the off-label conservative therapies in treating placenta accreta (PA). Until now, only a few mild adverse drug reactions (ADRs) have been published after short-term use of LDMTX, and no severe cases have been reported.

CASE SUMMARY

We present a case of a 30-year-old female who developed acute severe oral ulcerative mucositis with degree IV myelosuppression and degree III hepatic injury, after three doses of LDMTX to treat placenta accrete. The symptoms gradually improved after leucovorin rescue and supportive treatments.

WHAT IS NEW AND CONCLUSION

The present case provides the first severe ADR report for the short-term use of LDMTX for treating PA, indicating that potentially life-threatening complications can also occur when using LDMTX. Early recognition and immediate leucovorin rescue could result in a favourable outcome.

Identification of downstream target genes regulated by CX43 in hepatocellular carcinoma

The aim of study was to identify the downstream target genes of CX43 by Human Transcriptome Array. Therefore, a gene microarray was generated which consists of CX43-overexpressed hepatocellular carcinoma (HCC) cells transfected with the constructed plasmid and negative controls to identify candidate genes. Integrated bioinformatic analysis was used to clarify biological functions of the identified genes, including Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway, protein-protein interaction network, and survival analysis. The candidate genes were further validated by qRT-PCR in liver cancer tissues and CX43-silenced HCC cells. We have found the mRNA and protein levels of CX43 significantly upregulated in HCC cells transfected with CX43 constructed plasmid. We identified 928 differentially expressed genes including 394 upregulated and 534 downregulated genes, enriched in the cancer related functions and pathways by GO and KEGG pathway analysis. The protein-protein interaction network revealed 9 hub genes in this study. Statistical analysis indicated that upregulation of RALA and SRC was associated with poor prognosis in liver cancer. The differential expression of 2 candidate genes were further validated in HCC cells and tissues. In conclusion, protein-coding genes RALA and SRC could be target genes of CX43 and therapeutic targets for hepatocellular carcinoma.