Swertiamarin relieves radiation-induced intestinal injury by limiting DNA damage

Radiotherapy is the conventional treatment for pelvic abdominal tumors. However, it can cause some damage to the small intestine and colorectal, which are very sensitive to radiation. Radiation-induced intestinal injury (RIII) affects the prognosis of radiotherapy, causing sequelae of loss of function and long-term damage to patients' quality of life. Swertiamarin is a glycoside that has been reported to prevent a variety of diseases including but not limited to diabetes, hypertension, atherosclerosis, arthritis, malaria, and abdominal ulcers. However, its therapeutic effect and mechanism of action on RIII have not been established. We investigated whether swertiamarin has a protective effect against RIII. In this article, we use irradiator to create cellular and mouse models of radiation damage. Preventive administration of swertiamarin could reduce ROS and superoxide anion levels to mitigate the cellular damage caused by radiation. Swertiamarin also attenuated RIII in mice, as evidenced by longer survival, less weight loss and more complete intestinal barrier. We also found an increase in the relative abundance of primary bile acids in irradiated mice, which was reduced by both FXR agonists and swertiamarin, and a reduction in downstream interferon and inflammatory factors via the cGAS-STING pathway to reduce radiation-induced damage.

Systemic evaluation of novel acaricide hexythiazox for bioactivity improvement and risk reduction at the enantiomer level

Traditional risk assessments of chiral pesticides mainly depend on racemic form, which is often incomprehensive. This study conducted systemic investigations on the bioactivity, toxicity, and ecotoxicological effects of hexythiazox (HTZ) at the enantiomer level. The elution order and absolute configuration of HTZ enantiomers were determined. (4R, 5R)-(+)-HTZ exhibited 708 and 1719 times higher bioactivity against Tetranychus cinnabarinus and Tetranychus urticae eggs than (4S, 5S)-(-)-HTZ, respectively. Molecular docking indicated greater interactions between (4R, 5R)-(+)-HTZ and chitin synthase leading to higher bioactivity of (4R, 5R)-(+)-HTZ. However, (4S, 5S)-(-)-HTZ induced greater changes in protein and malondialdehyde content, and antioxidant and detoxification enzyme activities than (4R, 5R)-(+)-HTZ in earthworms. Furthermore, integrated biomarker response results indicated (4S, 5S)-(-)-HTZ exhibited higher toxic effects on earthworms than (4R, 5R)-(+)-HTZ. Finally, significant differentially expressed genes (DEGs) were observed in earthworms after exposure to (4R, 5R)-(+)-HTZ and (4S, 5S)-(-)-HTZ, respectively. These DEGs were mainly enriched in glycolysis/gluconeogenesis and purine metabolism pathways in earthworms. Additionally, six metabolism pathways were also enriched, including pyruvate metabolism, fatty acid biosynthesis, oxidative phosphorylation, citric acid cycle, fatty acid degradation, and ATP-binding cassette transporters. These findings suggest that earthworms exhibited enantiomer-specific responses to (4R, 5R)-(+)-HTZ and (4S, 5S)-(-)-HTZ. This study provides systemic insight into the toxicity mechanism of HTZ at the enantiomer level and the potential to develop (4R, 5R)-(+)-HTZ as a high-efficiency and low-risk pesticide.

Numerical Simulation of Compressive Mechanical Properties of 3D Printed Lattice-Reinforced Cement-Based Composites Based on ABAQUS

Research has established that the incorporation of 3D-printed lattice structures in cement substrates enhances the mechanical properties of cementitious materials. However, given that 3D-printing materials, notably polymers, exhibit varying degrees of mechanical performance under high-temperature conditions, their efficacy is compromised. Notably, at temperatures reaching 150 °C, these materials soften and lose their load-bearing capacity, necessitating further investigation into their compressive mechanical behavior in such environments. This study evaluates the compressibility of cement materials reinforced with lattice structures made from polyamide 6 (PA6) across different structural configurations and ambient temperatures, employing ABAQUS for simulation. Six distinct 3D-printed lattice designs with equivalent volume but varying configurations were tested under ambient temperatures of 20 °C, 50 °C, and 100 °C to assess their impact on compressive properties. The findings indicate that heightened ambient temperatures significantly diminish the reinforcing effect of 3D-printed materials on the properties of cement-based composites.

Single-cell atlas reveals the immunosuppressive microenvironment and Treg cells landscapes in recurrent Glioblastoma

Patients diagnosed with glioblastoma (GBM) have the most aggressive tumor progression and lethal recurrence. Research on the immune microenvironment landscape of tumor and cerebrospinal fluid (CSF) is limited. At the single-cell level, we aim to reveal the recurrent immune microenvironment of GBM and the potential CSF biomarkers and compare tumor locations. We collected four clinical samples from two patients: malignant samples from one recurrent GBM patient and non-malignant samples from a patient with brain tumor. We performed single-cell RNA sequencing (scRNA-seq) to reveal the immune landscape of recurrent GBM and CSF. T cells were enriched in the malignant tumors, while Treg cells were predominately found in malignant CSF, which indicated an inhibitory microenvironment in recurrent GBM. Moreover, macrophages and neutrophils were significantly enriched in malignant CSF. This indicates that they an important role in GBM progression. S100A9, extensively expressed in malignant CSF, is a promising biomarker for GBM diagnosis and recurrence. Our study reveals GBM's recurrent immune microenvironment after chemoradiotherapy and compares malignant and non-malignant CSF samples. We provide novel targets and confirm the promise of liquid CSF biopsy for patients with GBM.

Filler Mixed Into Adhesives Does Not Necessarily Improve Their Mechanical Properties

OBJECTIVES

To investigate the influence of filler type/loading on the micro-tensile fracture strength (μTFS) of adhesive resins, as measured 'immediately' upon preparation and after 1-week water storage ('water-stored').

METHODS

The morphology and particle-size distribution of three filler particles, referred to as 'Glass-S' (Esschem Europe), 'BioUnion' (GC), and 'CPC_Mont', were correlatively characterized by SEM, TEM, and particle-size analysis. These filler particles were incorporated into an unfilled adhesive resin ('BZF-29unfilled', GC) in different concentrations to measure the 'immediate' μTFS. After 1-week water storage, the 'water-stored' μTFS of the experimental particle-filled adhesive resins with the most optimum filler loading, specific for each filler type, was measured. In addition, the immediate and water-stored μTFS of the adhesive resins of three experimental two-step universal adhesives based on the same resin matrix but varying for filler type/loading, coded as 'BZF-21' (containing silica and bioglass), 'BZF-29' (containing solely silica), and 'BZF-29_hv' (highly viscous with a higher silica loading than BZF-29), and of the adhesive resins of the gold-standard adhesives OptiBond FL ('Opti-FL', Kerr) and Clearfil SE Bond 2 ('C-SE2', Kuraray Noritake) was measured along with that of BZF-29unfilled (GC) serving as control/reference. Statistics involved one-way and two-way ANOVA followed by post-hoc multiple comparisons (α<0.05).

RESULTS

Glass-S, BioUnion, and CPC_Mont represent irregular fillers with an average particle size of 8.5-9.9 μm. Adding filler to BZF-29unfilled decreased μTFS regardless of filler type/loading. One-week water storage reduced μTFS of all adhesive resins except BZF-21, with the largest reduction in μTFS recorded for BZF-29unfilled. Among the three filler types, the μTFS of the 30 wt% Glass-S and 20 wt% BioUnion filled adhesive resin was not significantly different from the μTFS of BZF-29unfilled upon water storage.

CONCLUSIONS

Adding filler particles into adhesive resin did not enhance its micro-tensile fracture strength but appeared to render it less sensitive to water storage as compared to the unfilled adhesive resin investigated.

Synthesis of salcaprozate sodium and its significance in enhancing pancreatic kininogenase absorption performance

We conducted pharmacokinetic research wherein salcaprozate sodium (SNAC) was utilized as a penetration enhancer by incorporating it into pancreatic kininogenase (PK) to improve the bioavailability of pancreatic kininogenase enteric-coated tablets. We conducted in vitro studies on PK using the Caco-2 cell model and quantified PK levels using the enzyme-linked immunosorbent assay (ELISA) method. We conducted methodological verification by blending SNAC and PK powders into enteric-coated capsules, and studied the pharmacokinetic characteristics. Based on the PK transport assay, the cumulative permeation rates of the test group that employed a SNAC to PK ratio of 32:1, 16:1, 8:1, 4:1, and 2:1 were 13.574%, 7.597%, 10.653%, 3.755%, and 2.523%, respectively. We conducted a uniformity test on the powder that contained a blend of SNAC and PK. The relative standard deviations (RSDs) for both the power containing SNAC and the power not containing SNAC were less than 10%. Based on the methodological verification, in vivo pharmacokinetic study of PK met the experimental requirements. As indicated by the results of in vivo pharmacokinetic research on rats, the test group (This group used SNAC) had a PK AUC0-12 h of 5679.747 ng/L*h and t1/2 of 4.569 h, while the control group (This group did not use SNAC) had a PK AUC0-12 h of 4639.665 ng/L*h and t1/2 of 3.13 h. This study has established a low-cost, environmentally friendly, and safe SNAC synthesis route with high process yield suitable for industrial production. SNAC demonstrates an absorption-enhancing effect on PK, and the optimal ratio of SNAC to PK is determined to be 32:1.

Effect of COVID-19 infection on pregnant women in plateau regions

OBJECTIVE

The present study aims to explore the effect of COVID-19 infection on pregnant women in plateau regions.

STUDY DESIGN

Data from 381 pregnant women infected with COVID-19 who underwent prenatal examination or treatment at Women and Children's Hospital of Tibet Autonomous Region between January 2020 and December 2022 and 314 pregnant women not infected with COVID-19 were retrospectively collected.

METHODS

The study participants were divided into an infected and non-infected group according to whether they were infected with COVID-19. Basic information (ethnicity, age, body mass index and gestational age [GA]), vaccination status, intensive care unit (ICU) admission and delivery outcomes were compared. Binary logistic regression was used to analyse the influencing factors of ICU admission.

RESULTS

The results revealed significant differences in the GA, vaccination rate, blood pressure, partial pressure of oxygen, white blood cell (WBC) count, ICU admission rate, preeclampsia rate, forearm presentation rate, thrombocytopenia rate, syphilis infection rate and placental abruption rate between the two groups (P < 0.05). A univariate analysis showed that COVID-19 infection, hepatitis B virus infection, the WBC count and hypoproteinaemia were risk factors for ICU admission. The results of the multivariate analysis of the ICU admission of pregnant women showed that COVID-19 infection (odds ratio [OR] = 4.271, 95 % confidence interval [CI]: 3.572-5.820, P < 0.05) was a risk factor for ICU admission and the WBC count (OR = 0.935, 95 % CI: 0.874-0.947, P < 0.05) was a protective factor for ICU admission.

CONCLUSION

Pregnant women are vulnerable to the adverse consequences of COVID-19 infection, and public health measures such as vaccination are needed to protect this population subgroup.

A review on the antibiotic florfenicol: Occurrence, environmental fate, effects, and health risks

Florfenicol, as a replacement for chloramphenicol, can tightly bind to the A site of the 23S rRNA in the 50S subunit of the 70S ribosome, thereby inhibiting protein synthesis and bacterial proliferation. Due to the widespread use in aquaculture and veterinary medicine, florfenicol has been detected in the aquatic environment worldwide. Concerns over the effects and health risks of florfenicol on target and non-target organisms have been raised in recent years. Although the ecotoxicity of florfenicol has been widely reported in different species, no attempt has been made to review the current research progress of florfenicol toxicity, hormesis, and its health risks posed to biota. In this study, a comprehensive literature review was conducted to summarize the effects of florfenicol on various organisms including bacteria, algae, invertebrates, fishes, birds, and mammals. The generation of antibiotic resistant bacteria and spread antibiotic resistant genes, closely associated with hormesis, are pressing environmental health issues stemming from overuse or misuse of antibiotics including florfenicol. Exposure to florfenicol at μg/L-mg/L induced hormetic effects in several algal species, and chromoplasts might serve as a target for florfenicol-induced effects; however, the underlying molecular mechanisms are completely lacking. Exposure to high levels (mg/L) of florfenicol modified the xenobiotic metabolism, antioxidant systems, and energy metabolism, resulting in hepatotoxicity, renal toxicity, immunotoxicity, developmental toxicity, reproductive toxicity, obesogenic effects, and hormesis in different animal species. Mitochondria and the associated energy metabolism are suggested to be the primary targets for florfenicol toxicity in animals, albeit further in-depth investigations are warranted for revealing the long-term effects (e.g., whole-life-cycle impacts, multigenerational effects) of florfenicol, especially at environmental levels, and the underlying mechanisms. This will facilitate the evaluation of potential hormetic effects and construction of adverse outcome pathways for environmental risk assessment and regulation of florfenicol.

The role and regulation of SIRT1 in pulmonary fibrosis

Pulmonary fibrosis (PF) is a progressive and fatal lung disease with high incidence and a lack of effective treatment, which is a severe public health problem. PF has caused a huge socio-economic burden, and its pathogenesis has become a research hotspot. SIRT1 is a nicotinamide adenosine dinucleotide (NAD)-dependent sirtuin essential in tumours, Epithelial mesenchymal transition (EMT), and anti-aging. Numerous studies have demonstrated after extensive research that it is crucial in preventing the progression of pulmonary fibrosis. This article reviews the biological roles and mechanisms of SIRT1 in regulating the progression of pulmonary fibrosis in terms of EMT, oxidative stress, inflammation, aging, autophagy, and discusses the potential of SIRT1 as a therapeutic target for pulmonary fibrosis, and provides a new perspective on therapeutic drugs and prognosis prospects.

Anoikis-related CTNND1 is associated with immuno-suppressive tumor microenvironment and predicts unfavorable immunotherapeutic outcome in non-small cell lung cancer

Background: Immunotherapy has greatly changed the treatment of advanced non-small cell lung cancer (NSCLC). Anoikis is a programmed cell death process associated with cancer. However, the correlation between anoikis-related genes and the tumor microenvironment (TME) features and immunotherapeutic outcome in NSCLC has not been fully explored. Methods: The bulk and single-cell transcriptome data of NSCLC were downloaded from TCGA and GEO databases. The distribution of anoikis-related genes on different cell types at the single-cell level was analyzed, and these genes specifically expressed by tumor cells and immunotherapy-related were further extracted. Next, the candidate gene CTNND1 was identified and its correlations with the TME features and immunotherapeutic outcome in NSCLC were explored in multiple public cohorts. Finally, an in-house cohort was used to determine the CTNND1 expression and immuno-correlation in NSCLC. Results: At single-cell atlas, we found that anoikis-related genes expressed specifically in tumor cells of NSCLC. By intersecting anoikis-related genes, immunotherapy-associated genes, and the genes expressed in tumor cells, we obtained a special biomarker CTNND1. In addition, cell-cell communication analysis revealed that CTNND1+ tumor cells communicated with immune subpopulations frequently. Moreover, we found that high expression of CTNND1 was related to immuno-suppressive status of NSCLC. The expression of CTNND1 and its immuno-correlation were also validated, and the results showed that CTNND1 was highly expressed in NSCLC tissues and tumors with high CTNND1 expression accompanied with low CD8+ T cells infiltration. Conclusions: Overall, our study reported that CTNND1 can be considered as a novel biomarker for the predication of immunotherapeutic responses and a potential target for NSCLC therapy.

Single-Cell Sequencing Technology and Its Application in the Study of Central Nervous System Diseases

The mammalian central nervous system consists of a large number of cells, which contain not only different types of neurons, but also a large number of glial cells, such as astrocytes, oligodendrocytes, and microglia. These cells are capable of performing highly refined electrophysiological activities and providing the brain with functions such as nutritional support, information transmission and pathogen defense. The diversity of cell types and individual differences between cells have brought inspiration to the study of the mechanism of central nervous system diseases. In order to explore the role of different cells, a new technology, single-cell sequencing technology has emerged to perform specific analysis of high-throughput cell populations, and has been continuously developed. Single-cell sequencing technology can accurately analyze single-cell expression in mixed-cell populations and collect cells from different spatial locations, time stages and types. By using single-cell sequencing technology to compare gene expression profiles of normal and diseased cells, it is possible to discover cell subsets associated with specific diseases and their associated genes. Therefore, scientists can understand the development process, related functions and disease state of the nervous system from an unprecedented depth. In conclusion, single-cell sequencing technology provides a powerful technology for the discovery of novel therapeutic targets for central nervous system diseases.

Effects and mechanisms of salidroside on the behavior of SPS-induced PTSD rats

Post-traumatic stress disorder (PTSD) is a complex mental disorder, closely associated with stress and traumatic events. Salidroside (Sal) has been reported to possess neuroprotective effects. However, the behavioral effects and mechanisms of Sal on PTSD remain unknown. In this study, we utilized a rat model of PTSD induced by single prolonged stress (SPS) and administered Sal intraperitoneally (25, 50, 75 mg/kg/d) for 14 days. We then examined the behavioral effects and underlying mechanisms of Sal on SPS-induced PTSD rats. Our findings demonstrated that Sal alleviated anxiety-like behavior and spatial learning and memory impairment in SPS-induced PTSD rats. Furthermore, Sal treatment preserved the histomorphology of the hippocampal region. It was observed that Sal protected against hippocampal neuronal apoptosis in PTSD rats by reducing the number of TUNEL-positive cells and modulating apoptosis-related proteins (Bcl-2 and Bax). Additionally, Sal inhibited the activation of the NF-κB/iNOS/COX-2 signaling pathway in the hippocampus of PTSD rats, thereby suppressing the release of inflammatory factors (TNF-α and IL-1β) and the activation of microglia. Notably, Sal increased the expression of synapse-associated proteins PSD95 and Synapsin I in the hippocampus, while also enhancing dendritic density in the region. In conclusion, our results demonstrated that Sal could attenuate SPS-induced PTSD-like behaviors by inhibiting hippocampal neuronal apoptosis, enhancing hippocampal synaptic plasticity, and reducing neuroinflammatory responses. These findings may provide a foundation for the potential clinical application of Sal in the treatment of PTSD.

Prognostic value of the systemic inflammation response index in patients with aneurismal subarachnoid hemorrhage and a Nomogram model construction

OBJECTIVE

To investigate the prognostic value of inflammatory markers, including neutrophil/lymphocyte ratio (NLR), derived neutrophil/lymphocyte ratio (dNLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), prognostic nutritional index (PNI), and systemic inflammation response index (SIRI) in patients with aneurismal subarachnoid hemorrhage (aSAH), and then develop a Nomogram prognostic model.

METHODS

We analysed 178 aSAH patients who underwent surgery at Subei People's Hospital of Jiangsu province from January 2015 to December 2017. Patients were divided into two groups according to Glasgow outcome scale (GOS) score at 3 months. Univariate and multivariate analysis were used to identify the association between inflammatory markers and prognosis. Subsequently, we identified the best cutoff of SIRI for unfavorable outcome using receiver operating characteristic (ROC) curve analysis and compared the clinical data between high and low SIRI levels. We further evaluated the additive value of SIRI by comparing prognostic nomogram models with and without it.

RESULTS

A total of 47 (26.4%) patients had a poor outcome. Multivariate logistic regression analysis showed that SIRI was an independent risk factor of poor outcome. The SIRI of 4.105 × 109/L was identified as the optimal cutoff value, patients with high SIRI levels had worse clinical status and higher rates of unfavorable outcome. ROC analysis showed that a nomogram model combining the SIRI and other conventional factors showed more favorable predictive ability than the model without the SIRI.

CONCLUSIONS

SIRI was independently correlated with unfavorable outcome in SAH patients, and the nomogram model combining the SIRI had more favorable discrimination ability.

A Study on Damage of T800 Carbon Fiber/Epoxy Composites under In-Plane Shear Using Acoustic Emission and Digital Image Correlation

In addition to measuring the strain, stress, and Young's modulus of materials through tension and compression, in-plane shear modulus measurement is also an important part of parameter testing of composites. Tensile testing of ±45° composite laminates is an economical and effective method for measuring in-plane shear strength. In this paper, the in-plane shear modulus of T800 carbon fiber/epoxy composites were measured through tensile tests of ±45° composite laminates, and acoustic emission (AE) was used to characterize the damage of laminates under in-plane shear loading. Factor analysis (FA) on acoustic emission parameters was performed and the reconstructed factor scores were clustered to obtain three damage patterns. Finally, the development and evolution of the three damage patterns were characterized based on the cumulative hits of acoustic emission. The maximum bearing capacity of the laminated plate is about 17.54 kN, and the average in-plane shear modulus is 5.42 GPa. The damage modes of laminates under in-plane shear behavior were divided into three types: matrix cracking, delamination and fiber/matrix interface debonding, and fiber fracture. The characteristic parameter analysis of AE showed that the damage energy under in-plane shear is relatively low, mostly below 2000 mV × ms, and the frequency is dispersed between 150-350 kHz.

Molecular docking technology and network pharmacology based on Rhapontici Radix-Cremastrae Pseudobulbus drug pair in treating breast cancer

OBJECTIVE

Network pharmacology is a bioinformatics-based research strategy for identifying the mechanisms of drugs and promoting drug development. This study used network pharmacology to investigate the mechanism of the Loulu-Cremastrae Pseudobulbus drug pair treating breast cancer (BC).

MATERIALS AND METHODS

The ingredients and potential targets of the drug pair were searched with Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCSMP). National Center for Biotechnology Information (NCBI) and gene cards were used to search the targets of BC. Networks of "drugs-components-targets" and protein-protein interaction were constructed through Cytoscape. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis were carried out through common targets. Using AutoDock tool, molecular docking was performed to verify the binding between key targets and compounds.

RESULTS

Finally, we selected 6 active compounds from the drug pair. A total of 61 targets were associated with the drug pair, and 15,295 targets were related to BC. 55 common targets were obtained after the intersection. The key targets included Transcription factor Jun (JUN), Heat shock protein HSP 90-alpha (HSP90AA1), and Caspase-3(CASP3). 327 terms were obtained by GO analysis. 78 pathways (p < 0.05) were identified through KEGG analysis. Molecular docking indicated that important compounds combined well with key targets.

CONCLUSIONS

Various active compounds, including beta-sitosterol, 2-methoxy-9,10-dihydrophenanthrene-4,5-diol, and stigmasterol, can regulate multiple signaling pathways related to BC, such as the estrogen and prolactin signaling pathways, playing therapeutic roles in BC.

Mechanism and Association between Microbial Nitrogen Transformation in Rhizosphere and Accumulation of Ciprofloxacin in Choysum (Brassica parachinensis)

Rhizosphere microbiota are an important factor impacting plant uptake of pollutants. However, little is known about how microbial nitrogen (N) transformation in the rhizosphere affects the uptake and accumulation of antibiotics in plants. Here, we determined recruitment of N transformation functional bacteria upon ciprofloxacin (CIP) exposure, by comparing differences in assembly processes of both rhizospheric bacterial communities and N transformation between two choysum (Brassica parachinensis) varieties differing in CIP accumulation. The low accumulation variety (LAV) of CIP recruited more host bacteria (e.g., Nitrospiria and Nitrolancea) carrying nitrification genes (mainly nxrA) but fewer host bacteria carrying denitrification genes, especially narG, relative to the high accumulation variety (HAV) of CIP. The nxrA and narG abundance in the LAV rhizosphere were, respectively, 1.6-7.8 fold higher and 1.4-3.4 fold lower than those in the HAV rhizosphere. Considering that nitrate can decrease CIP uptake into choysum through competing for the proton motive force and energy, such specific bacteria recruitment in LAV favored the production and utilization of nitrate in its rhizosphere, thus limiting its CIP accumulation with 1.6-2.4 fold lower than the HAV. The findings give insight into the mechanism underlying low pollutant accumulation, filling the knowledge gap regarding the profound effects of rhizosphere microflora and N transformation processes on antibiotic accumulation in crops.

Peripheral T-Cell Priming and Micrometastatic Disease Control with Metastasis-Directed Therapy: Multidimensional Immunogenomic Profiling of Oligometastatic Prostate Cancer in the EXTEND Trial

PURPOSE/OBJECTIVE(S)

Comprehensive metastasis-directed therapy (MDT) for oligometastatic prostate cancer extended progression-free survival (PFS) and time to new lesion formation in the intermittent hormone therapy (HT) basket of EXTEND. To better understand the mechanism of MDT benefit, we pooled the intermittent and continuous HT baskets of EXTEND and tested the hypothesis that adding MDT to HT would program systemic T-cells to control micrometastatic disease.

MATERIALS/METHODS

A total of 174 men were randomized to HT with or without MDT to up to 5 sites of metastases. HT was given for 6 months (intermittent basket, n = 87) or indefinitely (continuous basket, n = 87). Peripheral blood samples were drawn at enrollment, at the end of MDT, at 3 months follow-up (3 mo F/U), and at progression and then analyzed by flow cytometry, T-cell receptor (TCR)-β CDR3 variable region sequencing, multiplex cytokine profiling, and next-generation circulating tumor DNA (ctDNA) sequencing. TCR clonal expansion was determined using a published betabinomial model. Repertoire changes were assessed by Morisita's index, and dominant TCR repertoire motifs were characterized with ImmunoMap. Associations between blood markers and PFS were evaluated with Cox regression adjusted hazard ratios (aHR) accounting for randomization arm and stratifying for intermittent vs continuous HT.

RESULTS

Randomization to MDT+HT was associated with T-cell activation, proliferation, and clonal expansion. This response was first observed at end-MDT as upregulated expression of T-cell activation and inhibition markers (i.e., ICOS, Tim-3, and LAG-3) and increases in highly proliferative CD4+ and CD8+ Ki67hi T-cells (all P<0.05). TCR sequencing of 7,678,911 T-cells revealed that MDT+HT was associated with TCR clonal expansion, remodeling of the TCR repertoire, and changes in dominant TCR motifs at end-MDT and 3 mo F/U (all P<0.05). Observed T-cell priming could be driven by signaling networks of canonical T-cell stimulatory cytokines (IL-2, IL-12, and IL-15), which were upregulated at end-MDT and persisted at 3 mo F/U (all P<0.05). This modulation of T-cell phenotype, clonotype, and cytokine concentrations was not observed in the HT-monotherapy arm. At end-MDT, systemic T-cell responses were associated with improved PFS, most notably CD8+ T-cell expression of LAG-3 (aHR 0.22, 95% CI 0.03-0.91) and high TCR clonal expansion (aHR 0.13, 95% CI 0.02-0.52). High ctDNA burden at end-MDT correlated with worse PFS (aHR 1.41, 95% CI 1.04-2.54), as did CD8+ T-cell expression of inhibitory receptor TIGIT at 3 mo F/U (aHR 1.03, 95% CI 1.01-1.06).

CONCLUSION

The addition of MDT to HT induced systemic T-cell activation and expansion, which was not observed in the HT-only arm. This systemic immune response was independently associated with improved PFS. In addition to cytoreduction of macroscopic disease, MDT-induced immune education may be an important complementary mechanism of micrometastatic control in oligometastatic prostate cancer.

Addition of Metastasis-Directed Therapy to Standard of Care Systemic Therapy for Oligometastatic Breast Cancer (EXTEND): A Multicenter, Randomized Phase II Trial

PURPOSE/OBJECTIVE(S)

Prior retrospective and prospective evidence have suggested a potential survival benefit of adding metastasis-directed therapy (MDT) to standard of care systemic therapy for oligometastatic breast cancer. This has led to the increased utilization of MDT in this setting despite the lack of randomized evidence to support this approach. Furthermore, the recent presentation of NRG-BR002 has questioned the value of MDT. Thus, we evaluated whether the addition of MDT to systemic therapy improves PFS in oligometastatic breast cancer.

MATERIALS/METHODS

EXTEND (NCT03599765) is a phase II randomized basket trial for multiple solid tumors testing whether the addition of MDT improves PFS. The primary endpoint was pre-specified to be independently assessed and reported for the breast basket when a minimum of 6 months of follow-up had been reached. Patients with ≤5 metastases were randomized to standard of care systemic therapy with or without MDT. The choice of systemic therapy was at the discretion of the treating medical oncologist. Number of metastatic lesions and prior lines of systemic therapy for metastatic disease were used as stratification variables pre-randomization. The primary endpoint was progression-free survival (PFS) defined as time to randomization to date of clinical or radiographic progression or death. The study was designed to have 80% power to detect an improvement in median PFS from 18 to 36 months, with a type I error of 0.1.

RESULTS

Between September 2018 to July 2022, 43 patients were randomized. 22 patients were assigned to the MDT arm, and 21 patients to the no MDT arm. Three patients were not evaluable. The MDT arm patients were older vs the no-MDT arm patients (median 61.5 years vs 48 years, p = 0.01). Otherwise, the arms were well-balanced. Overall, 8 patients had triple negative disease (18.6%), and 12 patients (30%) had de novo metastatic disease. Of those patients with de novo presentation randomized to MDT, all except one had the primary tumor treated with surgery and radiation. At a median follow-up of 19.4 months, 20 events were observed. Among the 40 evaluable patients, there were 5 deaths (3 in the MDT arm and 2 in the no MDT arm). There was no difference in PFS between the MDT and no MDT arms (median 15.6 v 24.9 months, p = 0.66). Similarly, there was no difference in the secondary endpoint of time to new metastatic lesion appearance between the MDT and no MDT arms (median 15.6 months vs not reached, p = 0.09). Two grade 3 toxicities were observed in the MDT arm, and 1 in the no MDT arm. Further analysis of correlative translational biomarkers, including immune markers and ctDNA, are ongoing.

CONCLUSION

The addition of MDT to standard of care systemic therapy did not improve PFS or time to new metastatic lesion in patients with oligometastatic breast cancer. This data coupled with the recently presented NRG-BR002 results, suggests there is no benefit to MDT in an otherwise unselected oligometastatic breast cancer population.

Validation of the Prognostic Index for Spine Metastasis (PRISM) Score for Stratifying Survival in Patients Treated with Spinal Stereotactic Radiosurgery

PURPOSE/OBJECTIVE(S)

Stereotactic spinal radiosurgery (SSRS) has been increasingly utilized as a first-line treatment for the management of spine metastases due to its ability to prolong survival and improve symptom control. Studies have shown that SSRS is helpful for select patients; however, there is no universal scoring system utilized to predict patient response to treatment. The Prognostic Index for Spinal Metastases (PRISM) score was shown to predict the likelihood of patients benefiting from SSRS. We sought to further demonstrate its generalizability by performing validation with a large dataset from a second high-volume institution.

MATERIALS/METHODS

We performed a retrospective review from 2017-2019 of 424 patients treated with SSRS at a single institution. Patients were stratified on the previously described PRISM criteria: Female sex (+2), solitary bone disease (+3), performance status (0 through +3.5), prior surgery at the SSRS site (+1), number of other metastatic sites (-N), prior radiation at the SSRS site (-1), and latency to treatment ≥ 5 months (+3). Patients were grouped based on PRISM scores: >7, Group 1; 4-7, Group 2; 1-3, Group 3; <1 Group 4. There were 89, 188, 88, and 59 patients in Groups 1, 2, 3, and 4, respectively. Most patients were male (70%) with a performance status of 0 (53%). The most common tumor histologies were prostate (34%), renal (18%), and lung (11%). The median biological effective dose (BED10) was 60 Gy (interquartile range [IQR], 60-82). We performed Cox proportional hazards analysis on overall survival (OS) based on PRISM score and patient and tumor characteristics. Concordance indices created from PRISM criteria and the multivariate Cox proportional analysis were compared.

RESULTS

The median follow-up time was 50.5 months (95% confidence interval [CI], 45.8-54.7) with a median overall survival of 30.3 months (95% CI, 27.3-38.4). The median overall survivals for PRISM Groups 1, 2, 3, and 4 were 57.1, 37, 23.7, and 8.8 months, respectively. There were significant differences in overall survival among PRISM groups with hazard ratios of 0.49 (95% CI, 0.35-0.69; P<0.001) for Group 1, 0.71 (95% CI, 0.55-0.91); P<0.007) for Group 2, 1,45 (95% CI, 1.08-1.94); P = 0.010) for Group 3, and 3.47 (95% CI, 2.56-4.70; P<0.001) for Group 4. Multivariable Cox analysis for patient and tumor characteristics revealed only the number of organs involved and performance status as significant clinicopathologic prognostic attributes. However, the C-index using the PRISM criteria was 0.76, which was superior to the C-index when using the significant clinicopathologic attributes by themselves (0.71).

CONCLUSION

These data demonstrate robust validation of the PRISM score to stratify OS in patients treated with SSRS and may help guide optimal treatment selection in prospective trials and clinical settings.

Real-world implementation of non-endoscopic triage testing for Barrett's oesophagus during COVID-19

BACKGROUND

The Coronavirus pandemic (COVID-19) curtailed endoscopy services, adding to diagnostic backlogs. Building on trial evidence for a non-endoscopic oesophageal cell collection device coupled with biomarkers (Cytosponge), an implementation pilot was launched for patients on waiting lists for reflux and Barrett's oesophagus surveillance.

AIMS

(i) To review reflux referral patterns and Barrett's surveillance practices. (ii) To evaluate the range of Cytosponge findings and impact on endoscopy services.

DESIGN AND METHODS

Cytosponge data from centralized laboratory processing (trefoil factor 3 (TFF3) for intestinal metaplasia (IM), haematoxylin & eosin for cellular atypia and p53 for dysplasia) over a 2-year period were included.

RESULTS

A total of 10 577 procedures were performed in 61 hospitals in England and Scotland, of which 92.5% (N = 9784/10 577) were sufficient for analysis. In the reflux cohort (N = 4074 with gastro-oesophageal junction sampling), 14.7% had one or more positive biomarkers (TFF3: 13.6% (N = 550/4056), p53: 0.5% (21/3974), atypia: 1.5% (N = 63/4071)), requiring endoscopy. Among samples from individuals undergoing Barrett's surveillance (N = 5710 with sufficient gland groups), TFF3-positivity increased with segment length (odds ratio = 1.37 per cm (95% confidence interval: 1.33-1.41, P < 0.001)). Some surveillance referrals (21.5%, N = 1175/5471) had ≤1 cm segment length, of which 65.9% (707/1073) were TFF3 negative. Of all surveillance procedures, 8.3% had dysplastic biomarkers (4.0% (N = 225/5630) for p53 and 7.6% (N = 430/5694) for atypia), increasing to 11.8% (N = 420/3552) in TFF3+ cases with confirmed IM and 19.7% (N = 58/294) in ultra-long segments.

CONCLUSIONS

Cytosponge-biomarker tests enabled targeting of endoscopy services to higher-risk individuals, whereas those with TFF3 negative ultra-short segments could be reconsidered regarding their Barrett's oesophagus status and surveillance requirements. Long-term follow-up will be important in these cohorts.

A fine recognition method of strawberry ripeness combining Mask R-CNN and region segmentation

As a fruit with high economic value, strawberry has a short ripeness period, and harvesting at an incorrect time will seriously affect the quality of strawberries, thereby reducing economic benefits. Therefore, the timing of its harvesting is very demanding. A fine ripeness recognition can provide more accurate crop information, and guide strawberry harvest management more timely and effectively. This study proposes a fine recognition method for field strawberry ripeness that combines deep learning and image processing. The method is divided into three stages: In the first stage, self-calibrated convolutions are added to the Mask R-CNN backbone network to improve the model performance, and then the model is used to extract the strawberry target in the image. In the second stage, the strawberry target is divided into four sub-regions by region segmentation method, and the color feature values of B, G, L, a and S channels are extracted for each sub-region. In the third stage, the strawberry ripeness is classified according to the color feature values and the results are visualized. Experimental results show that with the incorporation of self-calibrated convolutions into the Mask R-CNN, the model's performance has been substantially enhanced, leading to increased robustness against diverse occlusion interferences. As a result, the final average precision (AP) has improved to 0.937, representing a significant increase of 0.039 compared to the previous version. The strawberry ripeness classification effect is the best on the SVM classifier, and the accuracy under the combined channel BGLaS reaches 0.866. The classification results are better than common manual feature extraction methods and AlexNet, ResNet18 models. In order to clarify the role of the region segmentation method, the contribution of different sub-regions to each ripeness is also explored. The comprehensive results demonstrate that the proposed method enables the evaluation of six distinct ripeness levels of strawberries in the complex field environment. This method can provide accurate decision support for strawberry refined planting management.

Resonant plasmonic detection of terahertz radiation in field-effect transistors with the graphene channel and the black-As[Formula: see text]P[Formula: see text] gate layer

We propose the terahertz (THz) detectors based on field-effect transistors (FETs) with the graphene channel (GC) and the black-Arsenic (b-As) black-Phosphorus (b-P), or black-Arsenic-Phosphorus (b-As[Formula: see text]P[Formula: see text]) gate barrier layer. The operation of the GC-FET detectors is associated with the carrier heating in the GC by the THz electric field resonantly excited by incoming radiation leading to an increase in the rectified current between the channel and the gate over the b-As[Formula: see text]P[Formula: see text] energy barrier layer (BLs). The specific feature of the GC-FETs under consideration is relatively low energy BLs and the possibility to optimize the device characteristics by choosing the barriers containing a necessary number of the b-As[Formula: see text]P[Formula: see text] atomic layers and a proper gate voltage. The excitation of the plasma oscillations in the GC-FETs leads to the resonant reinforcement of the carrier heating and the enhancement of the detector responsivity. The room temperature responsivity can exceed the values of [Formula: see text] A/W. The speed of the GC-FET detector's response to the modulated THz radiation is determined by the processes of carrier heating. As shown, the modulation frequency can be in the range of several GHz at room temperatures.

Anatomical Study and Clinical Application of Optic Canal Decompression Via Transethmoid-sphenoid Approach Under Endoscope

This study aimed to evaluate the safety and accuracy of the endoscopic transethmoid-sphenoid approach for optic canal decompression. Twelve sides of 6 adult cadaveric heads fixed in formalin were selected to simulate optic canal decompression using the endoscopic transethmoid-sphenoid approach. Furthermore, this approach was used for optic canal decompression in 10 patients (11 eyes) with optic nerve canal injury. Related anatomical structures were observed using a 0-degree endoscope, and the anatomical characteristics as well as the surgical data were collected. The maximum effective widths of the cranial opening, orbital opening, and middle segment of the canal that could be drilled open endoscopically were 7.82±2.63, 8.05±2.77, and 6.92±2.01 mm, respectively. The angle between the line linking the center point of the tubercular recess with the midpoint of the cranial opening of the optic canal and the horizontal coordinate was 17.23±1.34 degrees. At the orbital opening of the optic canal, the ophthalmic artery was located directly inferior to the optic nerve in 2 cases (16.7%) and laterally inferior to the optic nerve in 10 cases (83.3%). Six of the operational eyes were effective while the remaining 5 were ineffective. No postoperative complications such as bleeding, infection, or cerebrospinal fluid leakage were observed during the follow-up period (6-12 mo). In conclusion, optic canal decompression positively impacts the prognosis of partial traumatic optic neuropathy. Furthermore, the endoscopic transethmoid-sphenoid approach for optic canal decompression is a minimally invasive procedure that provides direct access and adequate decompression. This technique is easy to master and suitable for clinical applications.

Construction of a novel ESIPT and AIE-based fluorescent sensor for sequentially detecting Cu2+ and H2S in both living cells and zebrafish

The development of effective methods for tracking Cu²⁺ and H₂S in living organisms is urgently required due to their vital function in a variety of pathophysiological processes. In this work, a new fluorescent sensor BDF with excited-state intramolecular proton transfer (ESIPT) and aggregation-induced emission (AIE) features for the successive detection of Cu²⁺ and H₂S was constructed by introducing 3,5-bis(trifluoromethyl)phenylacetonitrile into the benzothiazole skeleton. BDF showed a fast, selective and sensitive fluorescence "turn off" response to Cu²⁺ in physiological media, and the situ-formed complex can serve as a fluorescence "turn on" sensor for highly selective detection of H₂S through the Cu²⁺ displacement approach. In addition, the detection limits of BDF for Cu²⁺ and H₂S were determined to be 0.05 and 1.95 μM, respectively. Encouraged by its favourable features, including strong red fluorescence from the AIE effect, large Stokes shift (285 nm), high anti-interference ability and good function at physiological pH as well as a low toxicity, BDF was successfully applied for the consequent imaging of Cu²⁺ and H₂S in both living cells and zebrafish, making it an ideal candidate for detecting and imaging of Cu²⁺ and H₂S in live systems.

Controlled Symmetry with Woods-Saxon Stochastic Resonance Enabled Weak Fault Detection

Weak fault detection with stochastic resonance (SR) is distinct from conventional approaches in that it is a nonlinear optimal signal processing to transfer noise into the signal, resulting in a higher output SNR. Owing to this special characteristic of SR, this study develops a controlled symmetry with Woods-Saxon stochastic resonance (CSwWSSR) model based on the Woods-Saxon stochastic resonance (WSSR), where each parameter of the model may be modified to vary the potential structure. Then, the potential structure of the model is investigated in this paper, along with the mathematical analysis and experimental comparison to clarify the effect of each parameter on it. The CSwWSSR is a tri-stable stochastic resonance, but differs from others in that each of its three potential wells is controlled by different parameters. Moreover, the particle swarm optimization (PSO), which can quickly find the ideal parameter matching, is introduced to attain the optimal parameters of the CSwWSSR model. Fault diagnosis of simulation signals and bearings was carried out to confirm the viability of the proposed CSwWSSR model, and the results revealed that the CSwWSSR model is superior to its constituent models.

Bonding performance of experimental HEMA-free two-step universal adhesives to low C-factor flat dentin

OBJECTIVES

Experimental two-step universal adhesives (2-UAs) providing a particle-filled hydrophobic adhesive resin with a significant film thickness to hydrophobically seal the adhesive interface were designed and synthesized. This study aimed to characterize their interfacial interaction with dentin, to determine whether the 2-UA formulations achieve durable bonding to low C-factor flat dentin and to measure their water sorption.

METHODS

Bonding effectiveness of 2-UAs that combine a 10-MDP-based primer with hydrophobic adhesive resins differing only for filler (BZF-21, BZF-29, and BZF-29_hv) were comparatively investigated with the commercial adhesive Clearfil SE Bond 2 (C-SE2, Kuraray Noritake). Adhesive-dentin interfaces were characterized with TEM. Adhesive-resin disks were immersed in distilled water at 37 °C for 1 week, 6 months and 1 year to measure water sorption and solubility. 'Immediate' and 'aged' micro-tensile bond strength (μTBS) of the adhesives applied in etch-and-rinse (E&R) and self-etch (SE) bonding mode to low C-factor flat dentin were measured. Statistical analyses involved linear mixed-effects (LME) modelling and Kruskal-Wallis testing (p < 0.05).

RESULTS

TEM revealed that E&R hybrid layers were more sensitive to aging than SE hybrid layers. Lower water sorption was recorded for all UAs compared with C-SE2. The immediate μTBS of BZF-21 and BZF-29 was not significantly different from that of C-SE2. The 1-year aged μTBS of all 2-UAs was significantly lower than that of C-SE2, except for BZF-29 applied in E&R mode. A significant reduction in μTBS upon 1-year aging was recorded for BZF-21 and BZF-29 applied in E&R mode. A significant difference in μTBS between E&R and SE bonding modes was recorded for all adhesives except BZF-21.

SIGNIFICANCE

Experimental 2-UAs with a hydrophobic adhesive-resin design produced± 20-μm thick adhesive-resin layers, absorbed less water and resulted in bonding performance that was more aging-resistant when applied in SE than in E&R bonding mode. The silica-filled BZF-29 2-UA revealed the most comparable bonding performance with C-SE2 in a low C-factor condition (flat dentin).

Effects and mechanisms of extremely cold environment on body response after trauma

With the outbreak of the Ukrainian crisis, extremely cold environment warfare has once again become the focus of international attention. People exposed to extremely cold environments may suffer from cold damage, further aggravate trauma, trigger high disability and mortality rates, and even cause serious sequelae. To declare the effects and mechanisms of the extremely cold environment on the body after trauma, this paper reviews, firstly, physiological reaction of human body in an extremely cold environment. Then, the post-traumatic body response in an extremely cold environment was introduced, and finally, the sequelae of trauma in extremely cold environment was further summarized in the paper. The results indicated that extremely cold environment can cause a series of damage to the body, especially the body after trauma. The extremely cold factor is a double-edged sword, showing a favorable and unfavorable side in different aspects. Moreover, in addition to the trauma suffered by the body, the subsequent sequelae such as cognitive dysfunction, anxiety, depression and even post-traumatic stress disorder may also be induced. The paper summarizes the human body's physiological response in an extremely cold environment, and declares the effects and mechanisms of the extremely cold environment on the body after trauma, which may provide a theoretical basis for effectively improving the level of combat trauma treatment in extremely cold regions.

Broadband Flexible Microstrip Antenna Array with Conformal Load-Bearing Structure

To enhance the load-bearing mechanical properties and broadband electromagnetic characteristics of the conformal antenna, a broadband microstrip antenna array with a conformal load-bearing structure is proposed in this paper, which consists of three flexible substrate layers and two honeycomb core layers stacked on each other. By combining the antenna and honeycomb core layer in a structural perspective, the antenna array is implemented in the composition function of surface conformability and load-bearing. Additionally, the sidelobe level of the antenna is suppressed based on the reflection surface loaded. Meanwhile, an equivalent model of a honeycomb core layer has been established and applied in the design of a conformal antenna with a load-bearing structure. The presented model increases the accuracy of simulated results and reduces the memory consumption and time of the simulation. The overall size of the proposed antenna array is 32.84 × 36.65 × 4.9 mm (1.36 λ₀ × 1.52 λ₀ × 0.2 λ₀, λ₀ is the wavelength at 12.5 GHz). The proposed antenna element and array have been fabricated and measured in the flat state and under other various bending states. Experiment results show the operating relative bandwidth of the antenna array is 20.68% (11.67-13.76 GHz and 14.33-14,83 GHz) in the flat state. Under different bending conditions, the proposed antenna array covers 24.16% (11.08-14.1 GHz), 23.82% (10.63-13.5 GHz), and 23.12% with 30°, 60°, and 90° in the xoz plane (11.55-14.33 GHz). In terms of mechanical load bearing, the structure has better performance than the traditional single-layer honeycomb core load-bearing structure antenna.

Transcranial alternating current stimulation combined with sound stimulation improves cognitive function in patients with Alzheimer's disease: Study protocol for a randomized controlled trial

Background

The number of patients with Alzheimer's disease (AD) worldwide is increasing yearly, but the existing treatment methods have poor efficacy. Transcranial alternating current stimulation (tACS) is a new treatment for AD, but the offline effect of tACS is insufficient. To prolong the offline effect, we designed to combine tACS with sound stimulation to maintain the long-term post-effect.

Materials and methods

To explore the safety and effectiveness of tACS combined with sound stimulation and its impact on the cognition of AD patients. This trial will recruit 87 patients with mild to moderate AD. All patients were randomly divided into three groups. The change in Alzheimer's Disease Assessment Scale-Cognitive (ADAS-Cog) scores from the day before treatment to the end of treatment and 3 months after treatment was used as the main evaluation index. We will also explore the changes in the brain structural network, functional network, and metabolic network of AD patients in each group after treatment.

Discussion

We hope to conclude that tACS combined with sound stimulation is safe and tolerable in 87 patients with mild to moderate AD under three standardized treatment regimens. Compared with tACS alone or sound alone, the combination group had a significant long-term effect on cognitive improvement. To screen out a better treatment plan for AD patients. tACS combined with sound stimulation is a previously unexplored, non-invasive joint intervention to improve patients' cognitive status. This study may also identify the potential mechanism of tACS combined with sound stimulation in treating mild to moderate AD patients.

Clinical Trial Registration

Clinicaltrials.gov, NCT05251649. Registered on February 22, 2022.

A red-emissive benzothiazole-based luminophore with ESIPT and AIE natures and its application for detecting and imaging hypochlorous acid

A new "ESIPT + AIE" based dye of benzothiazole with red emission and a large Stokes shift was constructed by combining 2-(2'-hydroxyphenyl)benzothiazole as the ESIPT unit and α-cyanostilbene as the AIE unit. The compound BACN was found to be a ideal HClO chemosensor, and presented palpable fluorescence and colorimetric responses toward HClO via the HClO-trigged oxidation cleavage of the ethylene bridge activated by the electron withdrawing cyano group. BACN was capable of recognizing HClO rapidly (12 s) and sensitively under physiological conditions, with good selectivity over other biologically pertinent substances. Thanks to strong red emission (λ_em = 606 nm) and large Stokes shift (213 nm) resulted from the combination of ESIPT and AIE effects, it was successfully utilized for the recognition of exogenous and endogenous HClO in living HeLa cells.

Transcranial alternating current stimulation combined with sound stimulation improves the cognitive function of patients with Alzheimer's disease: A case report and literature review

Transcranial alternating current stimulation (tACS) is a relatively new non-invasive brain electrical stimulation method for the treatment of patients with Alzheimer's disease (AD), but it has poor offline effects. Therefore, we applied a new combined stimulation method to observe the offline effect on the cognitive function of patients with AD. Here, we describe the clinical results of a case in which tACS combined with sound stimulation was applied to treat moderate AD. The patient was a 73-year-old woman with a 2-year history of persistent cognitive deterioration despite the administration of Aricept and Sodium Oligomannate. Therefore, the patient received tACS combined with sound stimulation. Her cognitive scale scores improved after 15 sessions and continued to improve at 4 months of follow-up. Although the current report may provide a new alternative therapy for patients with AD, more clinical data are needed to support its efficacy.

Processed electroencephalography: impact of patient age and surgical position on intraoperative processed electroencephalogram monitoring of burst-suppression

We previously reported that processed EEG underestimated the amount of burst suppression compared to off-line visual analysis. We performed a follow-up study to evaluate the reasons for the discordance. Forty-five patients were monitored intraoperatively with processed EEG. A computer algorithm was used to convert the SedLine® (machine)-generated burst suppression ratio into a raw duration of burst suppression. The reference standard was a precise off-line measurement by two neurologists. We measured other potential variables that may affect machine accuracy such as age, surgery position, and EEG artifacts. Overall, the median duration of bust suppression for all study subjects was 15.4 min (Inter-quartile Range [IQR] = 1.0-20.1) for the machine vs. 16.1 min (IQR = 0.3-19.7) for the neurologists' assessment; the 95% limits of agreement fall within - 4.86 to 5.04 s for individual 30-s epochs. EEG artifacts did not affect the concordance between the two methods. For patients in prone surgical position, the machine estimates had significantly lower overall sensitivity (0.86 vs. 0.97; p = 0.038) and significantly wider limits of agreement ([- 4.24, 3.82] seconds vs. [- 1.36, 1.13] seconds, p = 0.001) than patients in supine position. Machine readings for younger patients (age < 65 years) had higher sensitivity (0.96 vs 0.92; p = 0.021) and specificity (0.99 vs 0.88; p = 0.007) for older patients. The duration of burst suppression estimated by the machine generally had good agreement compared with neurologists' estimation using a more precise off-line measurement. Factors that affected the concordance included patient age and position during surgery, but not EEG artifacts.

Precise CO2 Reduction for Bilayer Graphene

It is of great significance to explore unique and diverse chemical pathways to convert CO₂ into high-value-added products. Bilayer graphene (BLG), with a tunable twist angle and band structure, holds tremendous promise in both fundamental physics and next-generation high-performance devices. However, the π-conjugation and precise two-atom thickness are hindering the selective pathway, through an uncontrolled CO₂ reduction and perplexing growth mechanism. Here, we developed a chemical vapor deposition method to catalytically convert CO₂ into a high-quality BLG single crystal with a room temperature mobility of 2346 cm² V^-1 s^-1. In a finely controlled growth window, the CO₂ molecule works as both the carbon source and the oxygen etchant, helping to precisely define the BLG nucleus and set a record growth rate of 300 μm h^-1.

Predictive Value of the Systemic Immune Inflammation Index for Adverse Outcomes in Patients With Acute Ischemic Stroke

Background and Purpose

The systemic immune-inflammation index, a new index based on platelets, neutrophils and lymphocytes, has been shown to be associated with outcomes of patients with venous sinus thrombosis and cancer. However, its application in acute ischemic stroke has rarely been reported. Therefore, we examined the relationship between systemic immune-inflammation index levels at hospital admission and the outcomes of patients 3 months after onset, and plotted a nomogram to predict the probability of adverse outcomes in patients with acute ischemic stroke.

Methods

We retrospectively analyzed a total of 208 patients with acute ischemic stroke who were admitted between January 2020 and December 2020, and recorded the modified Rankin score 3 months later. A modified Rankin score ≥ 3 was defined as an adverse outcome. Age, sex, NIHSS score, SII, hypertension and coronary heart disease were included in the binary logistic regression, and the nomogram was plotted with a regression equation.

Results

Receiver operating characteristic (ROC) curve analysis indicated that the best cutoff value of the systemic immune-inflammation index was 802.8, with a sensitivity of 70.9% and specificity of 58.2% (area under the curve: 0.657, 95% confidence interval: 0.572–0.742). The nomogram had a C index of 0.802. The average error of the calibration curves of the training set and the validation set was 0.021 and 0.034, respectively.

Conclusion

The systemic immune-inflammation index is associated with short-term adverse outcomes in patients with acute ischemic stroke, and the nomograms can predict the risk of adverse outcomes in patients with acute ischemic stroke.

Psychiatric traits and intracerebral hemorrhage: A Mendelian randomization study

BACKGROUND

Psychiatric traits have been associated with intracerebral hemorrhage (ICH) in observational studies, although their causal relationships remain uncertain. We used Mendelian randomization analyses to infer causality between psychiatric traits and ICH.

METHODS

We collected data from genome-wide association studies of ICH (n = 361,194) and eight psychiatric traits among Europeans, including mood swings (n = 451,619), major depressive disorder (n = 480,359), attention-deficit/hyperactivity disorder (n = 53,293), anxiety (n = 459,560), insomnia (n = 462,341), schizophrenia (n = 77,096), neuroticism (n = 374,323), and bipolar disorder (n = 51,710). We performed a series of bidirectional two-sample Mendelian randomization and related sensitivity analyses. A Bonferroni corrected threshold of p < 0.00625 (0.05/8) was considered to be significant, and p < 0.05 was considered suggestive of evidence for a potential association.

RESULTS

Mendelian randomization analyses revealed suggestive positive causality of mood swings on ICH (odds ratio = 1.006, 95% confidence interval = 1.001-1.012, p = 0.046), and the result was consistent after sensitivity analysis. However, major depressive disorder (p = 0.415), attention-deficit/hyperactivity disorder (p = 0.456), anxiety (p = 0.664), insomnia (p = 0.699), schizophrenia (p = 0.799), neuroticism (p = 0.140), and bipolar disorder (p = 0.443) are not significantly associated with the incidence of ICH. In the reverse Mendelian randomization analyses, no causal effects of ICH on mood swings (p = 0.565), major depressive disorder (p = 0.630), attention-deficit/hyperactivity disorder (p = 0.346), anxiety (p = 0.266), insomnia (p = 0.102), schizophrenia (p = 0.463), neuroticism (p = 0.261), or bipolar disorder (p = 0.985) were found.

CONCLUSION

Our study revealed that mood swings are suggestively causal of ICH and increase the risk of ICH. These results suggest the clinical significance of controlling mood swings for ICH prevention.

Mechanosensitive turnover of phosphoribosyl pyrophosphate synthetases regulates nucleotide metabolism

Cells coordinate their behaviors with the mechanical properties of the extracellular matrix (ECM). Tumor cells frequently harbor an enhanced nucleotide synthesis, presumably to meet the increased demands for rapid proliferation. Nevertheless, how ECM rigidity regulates nucleotide metabolism remains elusive. Here we show that shift from stiff to soft matrix blunts glycolysis-derived nucleotide synthesis in tumor cells. Soft ECM results in TNF receptor-associated factor 2 (TRAF2)-dependent K29 ubiquitination and degradation of phosphoribosyl pyrophosphate synthetase (PRPS)1/2. Recruitment of TRAF2 to PRPS1/2 requires phosphorylation of PRPS1 S285 or PRPS2 T285, which is mediated by low stiffness-activated large tumor suppressor (LATS)1/2 kinases. Further, non-phosphoryable or non-ubiquitinatable PRPS1/2 mutations maintain PRPS1/2 expression and nucleotide synthesis at low stiffness, and promote tumor growth and metastasis. Our findings demonstrate that PRPS1/2 stability and nucleotide metabolism is ECM rigidity-sensitive, and thereby highlight a regulatory cascade underlying mechanics-guided tumor metabolism reprogramming.

Morphological classification and clinical significance of medial malleolus based on computed tomography three-dimensional reconstruction

BACKGROUND

Internal malleolus fractures and postoperative functional limitations are serious complications of deltoid ligament repair, reconstruction, while studies on conducting beak. Anatomical structure classification of medial malleolus at home and abroad is reported rarely. Hence, this morphological study is mainly designed to investigate the anatomical morphological classification and clinical significance of medial malleolus based on computed tomography (CT) three-dimensional reconstruction.

MATERIALS AND METHODS

From October 2018 to January 2021, 373 patients who underwent CT examination of malleolus medialis joint in the Jiang'an Hospital of Traditional Chinese Medicine were observed. The medial malleolus was observed and classified; then, geometric parameters were measured according to different medial malleolus types.

RESULTS

According to the results of 373 cases, medial malleolus can be divided into four types: omega type (66%), radical sign type (16%), inverted triangle type (14%), and wave type (4%).

CONCLUSIONS

There are four main shapes: omega, inverted triangle, radical sign, and wave in the medial malleolus of all normal ankles. The measurement of medial malleolus parameters according to medial malleolus in different shapes was of importance to guide smooth operation of medial malleolus fixation and deltoid ligament reconstruction and epidemiological.