Near-natural streams: Spatial factors are key in shaping multiple facets of zooplankton α and β diversity

In near-natural basins, zooplankton are key hubs for maintaining aquatic food webs and organic matter cycles. However, the spatial patterns and drivers of zooplankton in streams are poorly understood. This study registered 165 species of zooplankton from 147 sampling sites (Protozoa, Rotifers, Cladocera and Copepods), integrating multiple dimensions (i.e., taxonomic, functional, and phylogenetic) and components (i.e., total, turnover, and nestedness) of α and β diversity. This study aims to reveal spatial patterns, mechanisms, correlations, and relative contribution of abiotic factors (i.e., local environment, geo-climatic, land use, and spatial factors) through spatial interpolation (ordinary kriging), mantel test, and variance partitioning analysis (VPA). The study found that α diversity is concentrated in the north, while β diversity is more in the west, which may be affected by typical habitat, hydrological dynamics and underlying mechanisms. Taxonomic and phylogenetic β diversity is dominated by turnover, and metacommunity heterogeneity is the result of substitution of species and phylogeny along environmental spatial gradients. Taxonomic and phylogenetic β diversity were strongly correlated (r from 0.91 to 0.95), mainly explained by historical/spatial isolation processes, community composition, generation time, and reproductive characteristics, and this correlation provides surrogate information for freshwater conservation priorities. In addition, spatial factors affect functional and phylogenetic α diversity (26%, 28%), and environmental filtering and spatial processes combine to drive taxonomic α diversity (10%) and phylogenetic β diversity (11%). Studies suggest that spatial factors are key to controlling the community structure of zooplankton assemblages in near-natural streams, and that the relative role of local environments may depend on the dispersal capacity of species. In terms of diversity conservation, sites with high variation in uniqueness should be protected (i) with a focus on the western part of the thousand islands lake catchment and (ii) increasing effective dispersal between communities to facilitate genetic and food chain transmission.

[The Miao medicine Sidaxue alleviates rheumatoid arthritis in rats possibly by downregulating matrix metalloproteinases]

OBJECTIVE

To explore the inhibitory effect of Sidaxue, a traditional Miao herbal medicine formula, on articular bone and cartilage destruction and synovial neovascularization in rats with collagen-induced arthritis (CIA).

METHODS

In a SD rat model of CIA, we tested the effects of daily gavage of Sidaxue at low, moderate and high doses (10, 20, and 40 g/kg, respectively) for 21 days, with Tripterygium glycosides (GTW) as the positive control, on swelling in the hind limb plantar regions by arthritis index scoring. Pathologies in joint synovial membrane of the rats were observed with HE staining, and serum TNF-α and IL-1β levels were detected with ELISA. The expressions of NF-κB p65, matrix metalloproteinase 1 (MMP1), MMP2 and MMP9 at the mRNA and protein levels in the synovial tissues were detected using real-time PCR and Western blotting. Network pharmacology analysis was conducted to identify the important target proteins in the pathways correlated with the therapeutic effects of topical Sidaxue treatment for RA, and the core target proteins were screened by topological analysis.

RESULTS

Treatment with GTW and Sidaxue at the 3 doses all significantly alleviated plantar swelling, lowered arthritis index scores, improved cartilage and bone damage and reduced neovascularization in CIA rats (P<0.05), and the effects of Sidaxue showed a dose dependence. Both GTW and Sidaxue treatments significantly lowered TNF-α, IL-1β, NF-κB p65, MMP1, MMP2, and MMP9 mRNA and protein expressions in the synovial tissues of CIA rats (P<0.05). Network pharmacological analysis identified MMPs as the core proteins associated with topical Sidaxue treatment of RA.

CONCLUSION

Sidaxue alleviates articular bone and cartilage damages and reduces synovial neovascularization in CIA rats possibly by downregulating MMPs via the TNF-α/IL-1β/NF-κB-MMP1, 2, 9 signaling pathway, and MMPs probably plays a key role in mediating the effect of Sidaxue though the therapeutic pathways other than oral administration.

[Clinical outcome of posterior lumbar interbody fusion combined with Ponte osteotomy for reconstruction of coronal sagittal plane balance in degenerative scoliosis]

Objective: To evaluate the clinical efficacy of posterior lumbar interbody fusion combined with Ponte osteotomy in the treatment of patients with degenerative scoliosis. Methods: The medical records and imaging data of degenerative scoliosis in department of orthopedics, Peking Union Medical College Hospital from 2013 to 2022 were retrospectively collected, and the shortest follow-up time was 1 year. A total of 38 patients were included, including 13 males and 25 females, aged 50-87(65.6±10.9) years old.The follow-up was12-119(43±20) months. Standing position full spine anteroposterior lateral X-ray examinations were performed on all patients preoperatively, postoperatively, and at latest follow-up. The length of hospital stay, complications, operation time, blood loss, instrumented segment, fusion segmen were recorded. The clinical scores and coronasagittal imaging indicators at three time points were compared. Results: The operation time was (274.5±70.5)min, and intraoperative blood loss was (619.2±93.5)ml. The coronal vertical axis was improved from (2.9±1.8)cm preoperatively to (1.2±1.0)cm postoperatively. The preoperative coronal Cobb angle was 16.6°±9.9° and the immediate postoperative correction was 6.4°±4.0°(t=-6.83, P<0.001). The difference was statistically significant (t=-6.12, P<0.001). The coronal Cobb Angle at the last follow-up was 5.7°±3.7°, and there was no significant orthopaedic loss at the last follow-up (t=-6.12, P<0.001).The sagittal vertical axis decreased from (5.6±3.9)cm preoperatively to (3.2±2.5) cm immediately after operation (t=-6.83,P<0.001), and was well maintained at the last follow-up[(2.7±1.8) cm,t=-7.77,P<0.001]. Lumbar lordosis increased from 21.8°±10.2° preoperatively to 35.8°±8.3° postoperatively(t=12.01, P<0.001)and 40.1°±8.6° at last follow-up(t=-10.21, P<0.001). Oswestry disability score (ODI score), visual analogue score (VAS) low back pain score and VAS leg pain score were also lower after surgery than before surgery (all P<0.05). Conclusion: Posterior lumbar interbody fusion combined with Ponte osteotomy can significantly improve the coronal and sagittal plane deformity and postoperative functional score in adult patients with degenerative scoliosis.

Existing levels of biodiversity and river location may determine changes from small hydropower developments

Global ecosystems are facing anthropogenic threats that affect their ecological functions and biodiversity. However, we still lack an understanding of how biodiversity can mediate the responses of ecosystems or communities to human disturbance across spatial gradients. Here, we examined how existing, spatial patterns of biodiversity influence the ecological effects of small hydropower plants (SHPs) on macroinvertebrates in river ecosystems. This study found that levels of biodiversity (e.g., number of species) can influence the degrees of its alterations by SHPs occurring along elevational gradients. The results of the study reveal that the construction of SHPs has various effects on biodiversity. For example, low-altitude areas with low biodiversity (species richness less than 12) showed a small increase in biodiversity compared to high-altitude areas (species richness more than 12) under SHP disturbances. The increases in the effective habitat area of the river segment could be a driver of the enhanced biodiversity in response to SHP effects. Changes in the numerically dominant species contributed to the overall level of community variation from disturbances. Location-specific strategies may mitigate the effects of SHPs and perhaps other disturbances.

Phytoplankton species composition as bioindicator in the largest fragmented channel of the Pearl River, China

To test the serial discontinuity concept (SDC) predictions in a regulated river ecosystem, environmental parameters and phytoplankton community structure were determined in a subtropical river (China) which was regulated by 11 cascade dams. Our results showed that total phosphorus (TP) and silicate during the wet period in several dams supported the SDC predictions. Variations of phytoplankton species composition in several cascade dams, such as Datengxia (DTX) and Changzhou (CZ), also supported the SDC predictions. Moreover, the stations near the dams showed the maximum or minimum values of total species numbers in each cascade segment. Predictive model indicated that the types of phytoplankton decreased in the middle reaches, conforming to SDC predictions. In the whole system of cascading dams, an increase in silicate concentration and phytoplankton communities in the downstream was also consistent with SDC predictions. Therefore, these findings aligned with the SDC predictions in the aspects of both single dam and whole cascade dam system to some extent. In future research, our aim is to further investigate the effects of cascade damming on additional phytoplankton-related indices in this aquatic ecosystem. We hope to gather more comprehensive data to fully validate the SDC predictions.

Spatiotemporal variation in macroplastic abundances along a subtropical Austral river system

Plastic pollution is a ubiquitous problem that poses a threat to society and the environment. The issue is especially pervasive in the aquatic environment, where large amounts of plastic debris accumulate from numerous anthropogenic pathways. Relatively little is known about the extent of macroplastics in African subtropical Austral rivers, where management strategies are lacking. This study quantifies and compares the variation in macroplastic abundances along the Mvudi River, South Africa, over four sites and four seasons. We observed a non-significant difference in macroplastic abundance and variation across sites and seasons, with pollution therefore widespread across these contexts. However, the diversity of plastic debris (i.e. γ-diversity value) decreased generally along sites, with most macroplastic items being collected during winter, and fewer macroplastic during autumn. We observed high abundances of macroplastic debris on the shoreline compared to the mainstream, with high proportional abundances of plastic bags and film (> 57.8%) macroplastic physical type across all sites and seasons. We also observed a high proportional abundance of the polymer polypropylene (> 25.3%) across seasons. The information derived from this study serves as the baseline for understanding seasonal variations in plastic debris and their driving factors on this and other subtropical Austral rivers.

Effect of occlusal stabilisation splint with or without arthroscopic disc repositioning on condylar bone remodelling in adolescent patients

The aim of this study was to investigate the treatment effects of a stabilisation splint (SS) with and without arthroscopic disc repositioning (ADR) on condylar bone remodelling in adolescent patients with anterior disc displacement without reduction (ADDwoR). Cone beam computed tomography and magnetic resonance imaging were used to analyse condylar bone remodelling, condyle position, and disc position. Twenty-two temporomandibular joints of 14 patients who underwent ADR (age range 12-20 years; mean follow-up 12.5 ± 7.8 months) and 21 temporomandibular joints of 14 patients who did not undergo ADR (age range 13-20 years; mean follow-up 11.1 ± 5.1 months) were included. The change in bone volume (P < 0.001), rate of bone volume change (P < 0.001), and change in condyle height (P = 0.031) were significantly greater in patients with ADR than in those without ADR. The changes in posterior joint space (P = 0.013), superior joint space (P = 0.020), and ratio of condyle sagittal position (P = 0.013) were significantly greater in patients with ADR than in those without ADR. All discs in patients who underwent ADR and one disc in those who did not undergo ADR were backward repositioned. In conclusion, in adolescent patients with ADDwoR, ADR with SS therapy achieved better condyle and disc position than SS therapy alone, and also induced bone generation.

Comparison of different macroinvertebrates bioassessment indices in a large near-natural watershed under the context of metacommunity theory

The metacommunity theory proposes that community structure and biodiversity are influenced by both local processes (such as environmental filtering) and regional processes (such as dispersal). Despite the extensive use of traditional bioassessments based on species-environment relationships, the impact of dispersal processes on these assessments has been largely overlooked. This study aims to compare correlations between various bioassessment indices, including Shannon Weiner (H'), Biological Monitoring Working Party (BMWP), average score per taxon (ASPT), biotic index (BI), and EPT taxa index (EPT), based on macroinvertebrates collected from 147 sampling sites in a subtropical Chinese near-natural catchment. Modified indices were calculated by removing species strongly influenced by dispersal processes to address the influence of dispersal processes. Their relationship with environmental factors was then compared to the original indices. The study employed random forest regression (RFR) to compare the explanatory power of environmental factors using the two sets of indices. The spearman rank correlation analysis was conducted to examine the correlation between indices and environmental factors. The river health assessment was performed based on both modified and original indices. The results reveal significant differences between original and modified indices (especially H' and BI) providing a more accurate reflection of environmental conditions. Furthermore, the sensitivity of the different indices to various environmental factors varied, leading to differences in the bioassessment results between the modified and the original indices. Notably, original H', BMWP, and ASPT overestimated the bioassessment results, whereas the original BI underestimated them. These findings offer valuable insights into bioassessment and river health assessment evaluation within the catchment and other interconnected freshwater ecosystems, such as lakes, reservoirs, and wetlands. Our study underscores the importance of assessing and mitigating the impact of dispersal processes on bioassessment to obtain a more precise representation of the status of freshwater ecosystems.

Phase II clinical trial of neoadjuvant anti-PD-1 (toripalimab) combined with axitinib in resectable mucosal melanoma

BACKGROUND

The outcome of patients with resectable mucosal melanoma is poor. Toripalimab combined with axitinib has shown impressive results in metastatic mucosal melanoma with an objective response rate of 48.3% and a median progression-free survival of 7.5 months in a phase Ib trial. It was hypothesized that this combination administered in the neoadjuvant setting might induce a pathologic response in resectable mucosal melanoma, so we conducted this trial.

PATIENTS AND METHODS

This single-arm phase II trial enrolled patients with resectable mucosal melanoma. Patients received toripalimab 3 mg/kg once every 2 weeks (Q2W) plus axitinib 5 mg two times a day (b.i.d.) for 8 weeks as neoadjuvant therapy, then surgery and adjuvant toripalimab 3 mg/kg Q2W starting 2 ± 1weeks after surgery for 44 weeks. The primary endpoint was the pathologic response rate according to the International Neoadjuvant Melanoma Consortium recommendations.

RESULTS

Between August 2019 and October 2021, 29 patients were enrolled and received treatment, of whom 24 underwent resection. The median follow-up time was 34.2 months (95% confidence interval 20.4-48.0 months). The pathologic response rate was 33.3% (8/24; 4 pathological complete responses and 4 pathological partial responses). The median event-free survival for all patients was 11.1 months (95% confidence interval 5.3-16.9 months). The median overall survival was not reached. Neoadjuvant therapy was tolerable with 8 (27.5%) grade 3-4 treatment-related adverse events and no treatment-related deaths. Tissue samples of 17 patients at baseline and after surgery were collected (5 responders and 12 nonresponders). Multiplex immunohistochemistry demonstrated a significant increase in CD3+ (P = 0.0032) and CD3+CD8+ (P = 0.0038) tumor-infiltrating lymphocytes after neoadjuvant therapy, particularly in pathological responders.

CONCLUSIONS

Neoadjuvant toripalimab combined with axitinib in resectable mucosal melanoma demonstrated a promising pathologic response rate with significantly increased infiltrating CD3+ and CD3+CD8+ T cells after therapy.

Comparison of cryobiopsy and forceps biopsy for the diagnosis of mediastinal lesions: A randomised clinical trial

INTRODUCTION

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is the standard approach for lung cancer staging. However, its diagnostic utility for other mediastinal diseases might be hampered by the limited tissue retrieved. Recent evidence suggests the novel sampling strategies of forceps biopsy and cryobiopsy as auxiliary techniques to EBUS-TBNA, considering their capacity for larger diagnostic samples.

METHODS

This study determined the added value of forceps biopsy and cryobiopsy for the diagnosis of mediastinal diseases. Consecutive patients with mediastinal lesions of 1 cm or more in the short axis were enrolled. Following completion of needle aspiration, three forceps biopsies and one cryobiopsy were performed in a randomised pattern. Primary endpoints included diagnostic yield defined as the percentage of patients for whom mediastinal biopsy led to a definite diagnosis, and procedure-related complications.

RESULTS

In total, 155 patients were recruited and randomly assigned. Supplementing EBUS-TBNA with either forceps biopsy or cryobiopsy increased diagnostic yield, with no significant difference between EBUS-TBNA plus forceps biopsy and EBUS-TBNA plus cryobiopsy (85.7 % versus 91.6 %, P = 0.106). Yet, samples obtained by additional cryobiopsies were more qualified for lung cancer molecular testing than those from forceps biopsies (100.0 % versus 89.5 %, P = 0.036). When compared directly, the overall diagnostic yield of cryobiopsy was superior to forceps biopsy (85.7 % versus 70.8 %, P = 0.001). Cryobiopsies produced greater samples in shorter procedural time than forceps biopsies. Two (1.3 %) cases of postprocedural pneumothorax were detected.

CONCLUSIONS

Transbronchial mediastinal cryobiopsy might be a promising complementary tool to supplement traditional needle biopsy for increased diagnostic yield and tissue harvesting.

TRIAL REGISTRATION

ChiCTR2000030373.

[The multisystem deformities features of Klippel-Feil syndrome patients combined with congenital scoliosis]

Objective: To summarize the characteristics of multisystem deformities in patients with Klippel-Feil syndrome (KFS) combined with congenital scoliosis (CS). Methods: Within the framework of the "Deciphering Disorders Involving Scoliosis and Comorbidities (DISCO)" research collaboration, a retrospective analysis was conducted on patients diagnosed with KFS and CS at Peking Union Medical College Hospital between April 2005 and August 2022. Patient data, including imaging examinations and medical records, were collected to summarize the spinal and associated deformities. Results: A total of 82 KFS patients with concurrent CS were included, comprising 42 males and 40 females. The average age was (12.8±8.9) years. Among the KFS patients, there were 31 cases of Type Ⅰ, 12 cases of Type Ⅱ, and 39 cases of Type Ⅲ. The most common location for the major curve of scoliosis was the mid-thoracic segment (42 cases, 51.2%). Hemivertebrae deformities were most frequently observed in the upper thoracic segment (31 cases, 60.8%). There were no statistically significant differences in age, gender, major curve Cobb angle, or region of hemivertebrae occurrence among the different types of KFS (all P>0.05). Apart from spinal vertebral deformities, intraspinal deformities had the highest comorbidity rate (33 cases, 40.2%). The subjects were divided into two groups based on the presence or absence of intraspinal deformity (absence as group G0, presence as group G1), there was a statistically significant difference in the main Cobb angle [M(Q1, Q3)] between the two groups, which was 45.0° (27.5°, 62.0°) and 60.0° (37.5°, 83.5°), respectively (P=0.044). Additionally, a portion of the patients had concurrent cardiovascular system abnormalities (13 cases, 15.9%), craniofacial-ocular-auricular abnormalities (8 cases, 9.8%), genitourinary system abnormalities (7 cases, 8.5%), and gastrointestinal abnormalities (2 cases, 2.4%). Conclusions: Patients with KFS combined with CS commonly present with a major curve of spinal deformity in the mid-thoracic segment and often have comorbidities involving multiple systems. When combined with intraspinal anomalies, the major curve exhibits a greater degree of curvature.

[Clinicopathological and molecular features of metaplastic thymoma]

Objective: To investigate the clinicopathological features, and molecular genetic alterations of metaplastic thymoma (MT). Methods: A total of ten MT cases, diagnosed from 2011 to 2021, were selected from the Department of Pathology of Jinling Hospital, Nanjing University Medical School, Nanjing, China for clinicopathological and immunohistochemical (IHC) examination and clinical follow-up. Fluorescence in situ hybridization (FISH), next-generation sequencing (NGS), and YAP1 C-terminus (YAP1-CT) IHC were performed to detect YAP1::MAML2 fusions. Results: There were four males and six females, ranging in age from 29 to 60 years (mean 50 years, median 54 years). Microscopically, all tumors showed a typical biphasic morphology consisting of epithelial components and gradually or abruptly transitioning spindle cell components. The two components were present in varying proportions in different cases. Immunophenotypically, the epithelial cells were diffusely positive for CKpan, CK5/6 and p63. The spindle cells were diffusely positive for vimentin and focally positive for EMA. TdT was negative in the background lymphocytes. Ki-67 proliferation index was less than 5%. YAP1 and MAML2 break-apart FISH analyses showed that all ten cases had narrow split signals with a distance of nearly 2 signal diameters and may be considered false-negative. Using YAP1::MAML2 fusion FISH assays, abnormal fusion signals were observed in all the ten cases. NGS demonstrated YAP1::MAML2 fusions in all eight cases with adequate nucleic acids; in two cases the fusions were detected by DNA sequencing and in eight cases by RNA sequencing. All ten cases of MT demonstrated loss of YAP1 C-terminal expression in epithelioid cells. Conclusions: MT is a rare and low-grade thymic tumor characterized by a biphasic pattern and YAP1::MAML2 fusions. Break-apart FISH assays may sometimes show false-negative results due to the proximity of YAP1 and MAML2, while YAP1 C-terminal IHC is a highly sensitive and specific marker for MT. Loss of YAP1 C-terminal expression can also be used to screen YAP1::MAML2 fusions for possible MT cases.

[Diagnostic values of conventional tumor markers and their combination with chest CT for patients with stageⅠA lung cancer]

Objective: To investigate the diagnostic efficiency of conventional serum tumor markers and their combination with chest CT for stage ⅠA lung cancer. Methods: A total of 1 155 patients with stage ⅠA lung cancer and 200 patients with benign lung lesions (confirmed by surgery) treated at the Cancer Hospital, Chinese Academy of Medical Sciences from January 2016 to October 2020 were retrospectively enrolled in this study. Six conventional serum tumor markers [carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), squamous cell carcinoma associated antigen (SCCA), cytokeratin 19 fragment (CYFRA21-1), neuron-specific enolase (NSE), and gastrin-releasing peptide precursor (ProGRP)] and chest thin-slice CT were performed on all patients one month before surgery. Pathology was taken as the gold standard to analyze the difference of positivity rates of tumor markers between the lung cancer group and the benign group, the moderate/poor differentiation group and the well differentiation group, the adenocarcinoma group and the squamous cell carcinoma group, the lepidic and non-lepidic predominant adenocarcinoma groups, the solid nodule group and the subsolid nodule group based on thin-slice CT, and subgroups of ⅠA1 to ⅠA3 lung cancers. The diagnostic performance of tumor markers and tumor markers combined with chest CT was analyzed using the receiver operating characteristic curve. Results: The positivity rates of six serum tumor markers in the lung cancer group and the benign group were 2.32%-20.08% and 0-13.64%, respectively; only the SCCA positivity rate in the lung cancer group was higher than that in the benign group (10.81% and 0, P=0.022). There were no significant differences in the positivity rates of other serum tumor markers between the two groups (all P>0.05). The combined detection of six tumor markers showed that the positivity rate of the lung cancer group was higher than that of the benign group (40.93% and 18.18%, P=0.004), and the positivity rate of the adenocarcinoma group was lower than that of the squamous cell carcinoma group (35.66% and 47.41%, P=0.045). The positivity rates in the poorly differentiated group and moderately differentiated group were higher than that in the well differentiated group (46.48%, 43.75% and 22.73%, P=0.025). The positivity rate in the non-lepidic adenocarcinoma group was higher than that in lepidic adenocarcinoma group (39.51% and 21.74%, P=0.001). The positivity rate of subsolid nodules was lower than that of solid nodules (30.01% vs 58.71%, P=0.038), and the positivity rates of stageⅠA1, ⅠA2 and ⅠA3 lung cancers were 33.33%, 48.96% and 69.23%, respectively, showing an increasing trend (P=0.005). The sensitivity and specificity of the combined detection of six tumor markers in the diagnosis of stage ⅠA lung cancer were 74.00% and 56.30%, respectively, and the area under the curve (AUC) was 0.541. The sensitivity and specificity of the combined detection of six serum tumor markers with CT in the diagnosis of stage ⅠA lung cancer were 83.0% and 78.3%, respectively, and the AUC was 0.721. Conclusions: For stage ⅠA lung cancer, the positivity rates of commonly used clinical tumor markers are generally low. The combined detection of six markers can increase the positivity rate. The positivity rate of markers tends to be higher in poorly differentiated lung cancer, squamous cell carcinoma, or solid nodules. Tumor markers combined with thin-slice CT showed limited improvement in diagnostic efficiency for early lung cancer.

[Observation on the efficacy of different targets low-frequency repetitive transcranial magnetic stimulation for the treatment of tremor-dominant subtypes of Parkinson's disease]

Objective: To analyze the efficacy of different targets low-frequency repetitive transcranial magnetic stimulation (rTMS) for the treatment of tremor Parkinson's disease(PD). Method: A total of 82 patients with primary PD who were admitted to the Department of Neurology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from April 1, 2020 to March 31, 2021 were prospectively collected. According to the clinical characteristics of major movement disorders, 82 patients with tremor type (TD) were selected to enroll.The patients were randomly divided into 3 groups at a 1∶1∶1 ratio according to the randomized coding sequence of the trial: the primary motor cortex (M1) group with 26 cases, the cerebellum group with 26 cases and the dual-site (M1, cerebellum) group with 30 cases. All patients were treated with 1 Hz low-frequency stimulation of the corresponding target once a day for 5 days a week for 2 weeks, a total of 10 times; The dosage remained unchanged during the treatment for all groups. Before and after 2 weeks' treatment, the patients were assessed with the Unified PD Rating Scale (UPDRS) and PD Quality of Life Questionnaire-39 (PDQ-39) without medication. Cortical excitability, namely transcranial magnetic stimulation motor evoked potential (TMS-MEP), [including resting motor threshold (rMT) and active motor threshold (aMT) examinations], timed up and go (TUG) and electromyographic tremor were conducted. Result: There were 82 patients, 39 males and 43 females, with an average age of (67±8) years. Before the treatment, there was no statistically significant difference in the evaluation indicators among the three groups (all P>0.05). After the treatment, the differences of the UPDRS-Ⅲ score [(38.9±2.5) vs (29.2±3.6) ], UPDRS tremor score [(23.7±2.1) vs (14.6±3.1) ], TUG time [(44.8±3.1) s vs (33.7±4.1) s], tremor amplitude [(480±126) μV vs (276±94) μV], PDQ-39 score [(51±13) vs (45±13) ], rMT [(36±17)% vs (43±13)%], and aMT [(26±16)% vs (31±12)%] were statistically significant (all P<0.01) from those before the treatment. There was no statistical difference in the above factors between the M1 group and cerebellum group (all P>0.05). There was no statistically significant difference in tremor peak frequency among the three groups before and after the treatment (all P>0.05). Conclusions: Dual-site low-frequency rTMS can improve PD tremor, while M1 or cerebellar low-frequency rTMS does not significantly improve PD tremor. Its mechanism may be to improve PD tremor symptoms by regulating cortical excitability.

Microplastic abundance, distribution, and diversity in water and sediments along a subtropical river system

Microplastic pollution in aquatic environments has been a ubiquitous concern in recent years, owing to their rapid production combined with poor waste management practices. However, information on freshwater microplastics in the Global South is still scarce, despite growing research on freshwater microplastics in recent years, particularly within the Global North. To help address this knowledge gap, we studied water and sediment microplastic dynamics along a subtropical river system, i.e. Crocodile River around the Nelspruit City area (South Africa), across three different seasons (i.e. cool-dry, hot-dry, hot-wet) using a combination of diversity indices and multivariate analyses. Microplastics were more abundant during the cool-dry season in the surface water samples (mean 1058 particles m-3) and high during the hot-dry season (mean 568 particles kg-1 dwt) in the sediment samples. The hot-wet season had a low particle density in both surface water (mean 625 particles m-3) and sediments (mean 86 particles kg-1 dwt) samples. Microplastic shapes were dominated by fibres and fragments, with the colour scheme dominated by transparent, blue, and black. The abundance of microplastics was positively correlated with pH and resistivity, and negatively with river flow. Wastewater was attributed as a primary source of microplastics, particularly because of the observed dominant fibre microplastics, usually released during laundry. Our results suggest that Crocodile River and its tributaries are temporary sinks of microplastics during periods of low rainfall. Implications of this pollution are far-reaching, including effects on residents who are dependent on the Crocodile River as a source of drinking water and aquatic biota which may be exposed to these pollutants.

Randomized phase II adjuvant trial to compare two treatment durations of icotinib (2 years versus 1 year) for stage II-IIIA EGFR-positive lung adenocarcinoma patients (ICOMPARE study)

BACKGROUND

Despite the prolonged median disease-free survival (DFS) by adjuvant targeted therapy in non-small-cell lung cancer patients with epidermal growth factor receptor (EGFR) mutations, the relationship between the treatment duration and the survival benefits in patients remains unknown.

PATIENTS AND METHODS

In this multicenter, randomized, open-label, phase II trial, eligible patients aged 18-75 years with EGFR-mutant, stage II-IIIA lung adenocarcinoma and who had not received adjuvant chemotherapy after complete tumor resection were enrolled from eight centers in China. Patients were randomly assigned (1 : 1) to receive either 1-year or 2-year icotinib (125 mg thrice daily). The primary endpoint was DFS assessed by investigator. The secondary endpoints were overall survival (OS) and safety. This study was registered at ClinicalTrials.gov (NCT01929200).

RESULTS

Between September 2013 and October 2018, 109 patients were enrolled (1-year group, n = 55; 2-year group, n = 54). Median DFS was 48.9 months [95% confidence interval (CI) 33.1-70.1 months] in the 2-year group and 32.9 months (95% CI 26.6-44.8 months) in the 1-year group [hazard ratio (HR) 0.51; 95% CI 0.28-0.94; P = 0.0290]. Median OS for patients was 75.8 months [95% CI 64.4 months-not evaluable (NE)] in the 2-year group and NE (95% CI 66.3 months-NE) in the 1-year group (HR 0.34; 95% CI 0.13-0.95; P = 0.0317). Treatment-related adverse events (TRAEs) were observed in 41 of 55 (75%) patients in the 1-year group and in 36 of 54 (67%) patients in the 2-year group. Grade 3-4 TRAEs occurred in 4 of 55 (7%) patients in the 1-year group and in 3 of 54 (6%) patients in the 2-year group. No treatment-related deaths or interstitial lung disease was reported.

CONCLUSIONS

Two-year adjuvant icotinib was shown to significantly improve DFS and provide an OS benefit in EGFR-mutant, stage II-IIIA lung adenocarcinoma patients compared with 1-year treatment in this exploratory phase II study.

[A systematic review of the epidemiology and clinical characteristics of artificial stone-related silicosis and dust protection]

Objective: To investigate the epidemiology, clinical characteristics, on-site dust monitoring and individual protection of the patients with artificial stone-related silicosis. Methods: In March 2022, the literature on artificial stone-related silicosis published from January 1965 to February 2022 was searched in China Journal Full-text Database, Wanfang Database, VIP Database, EMbase and PubMed. Chinese and English search terms include "silica dust""silica dust""silicosis""artificial stone""pneumoconiosis", etc. References were included according to inclusion and exclusion criteria, and data were extracted. The epidemiological characteristics, natural course of disease, workplace dust concentration and individual protection level of patients with artificial stone-related silicosis were analyzed by systematic review. Results: A total of 30 literatures were included, including 7 cohort studies, 14 cross-sectional studies, 3 case-control studies and 6 case reports. A total of 1358 patients with artificial stone-related silicosis were diagnosed from 1997 to 2020, with an average age of 41.5 years old and an average dust exposure time of 11.3 years. Among them, 36.2% (282/778) had progressive mass fibrosis or accelerated progressive silicosis at first diagnosis. Chest imaging showed diffuse small nodule shadow, pulmonary fibrosis, and silico-alveolar proteinosis. Pulmonary function showed restricted or mixed ventilation disorder with or without decreased diffusion volume. The disease progressed rapidly, with progressive mass fibrosis, respiratory failure, and even death. Patients engaged in artificial quartz stone processing, with high concentration of silica including ultra-fine particles, most of which were dry operation, lack of on-site ventilation measures and no effective personal protection. Conclusion: The artificial stone processing workers suffer from artificial stone-related silicosis due to dry cutting, lack of on-site dust removal facilities and personal protective measures, and the disease progresses rapidly, leading to poor prognosis.

[HbA1c comparison and diagnostic efficacy analysis of multi center different glycosylated hemoglobin detection systems]

Objective: Compare and analyze the results of the domestic Lanyi AH600 glycated hemoglobin analyzer and other different detection systems to understand the comparability of the detection results of different detectors, and establish the best cut point of Lanyi AH600 determination of haemoglobin A1c (HbA1c) in the diagnosis of diabetes. Methods: Multi center cohort study was adopted. The clinical laboratory departments of 18 medical institutions independently collected test samples from their respective hospitals from March to April 2022, and independently completed comparative analysis of the evaluated instrument (Lanyi AH600) and the reference instrument HbA1c. The reference instruments include four different brands of glycosylated hemoglobin meters, including Arkray, Bio-Rad, DOSOH, and Huizhong. Scatter plot was used to calculate the correlation between the results of different detection systems, and the regression equation was calculated. The consistency analysis between the results of different detection systems was evaluated by Bland Altman method. Consistency judgment principles: (1) When the 95% limits of agreement (95% LoA) of the measurement difference was within 0.4% HbA1c and the measurement score was≥80 points, the comparison consistency was good; (2) When the measurement difference of 95% LoA exceeded 0.4% HbA1c, and the measurement score was≥80 points, the comparison consistency was relatively good; (3) The measurement score was less than 80 points, the comparison consistency was poor. The difference between the results of different detection systems was tested by paired sample T test or Wilcoxon paired sign rank sum test; The best cut-off point of diabetes was analyzed by receiver operating characteristic curve (ROC). Results: The correlation coefficient R² of results between Lanyi AH600 and the reference instrument in 16 hospitals is≥0.99; The Bland Altman consistency analysis showed that the difference of 95% LoA in Nanjing Maternity and Child Health Care Hospital in Jiangsu Province (reference instrument: Arkray HA8180) was -0.486%-0.325%, and the measurement score was 94.6 points (473/500); The difference of 95% LoA in the Tibetan Traditional Medical Hospital of TAR (reference instrument: Bio-Rad Variant II) was -0.727%-0.612%, and the measurement score was 89.8 points; The difference of 95% LoA in the People's Hospital of Chongqing Liang Jiang New Area (reference instrument: Huizhong MQ-2000PT) was -0.231%-0.461%, and the measurement score was 96.6 points; The difference of 95% LoA in the Taihe Hospital of traditional Chinese Medicine in Anhui Province (reference instrument: Huizhong MQ-2000PT) was -0.469%-0.479%, and the measurement score was 91.9 points. The other 14 hospitals, Lanyi AH600, were compared with 4 reference instrument brands, the difference of 95% LoA was less than 0.4% HbA1c, and the scores were all greater than 95 points. The results of paired sample T test or Wilcoxon paired sign rank sum test showed that there was no statistically significant difference between Lanyi AH600 and the reference instrument Arkray HA8180 (Z=1.665,P=0.096), with no statistical difference. The mean difference between the measured values of the two instruments was 0.004%. The comparison data of Lanyi AH600 and the reference instrument of all other institutions had significant differences (all P<0.001), however, it was necessary to consider whether it was within the clinical acceptable range in combination with the results of the Bland-Altman consistency analysis. The ROC curve of HbA1c detected by Lanyi AH600 in 985 patients with diabetes and 3 423 patients with non-diabetes was analyzed, the area under curve (AUC) was 0.877, the standard error was 0.007, and the 95% confidence interval 95%CI was (0.864, 0.891), which was statistically significant (P<0.001). The maximum value of Youden index was 0.634, and the corresponding HbA1c cut point was 6.235%. The sensitivity and specificity of diabetes diagnosis were 76.2% and 87.2%, respectively. Conclusion: Among the hospitals and instruments currently included in this study, among these four hospitals included Nanjing Maternity and Child Health Care Hospital in Jiangsu Province (reference instrument: Arkray HA8180), Tibetan Traditional Medical Hospital of TAR (reference instrument: Bio-Rad Variant Ⅱ), the People's Hospital of Chongqing Liang Jiang New Area (reference instrument: Huizhong MQ-2000PT), and the Taihe Hospital of traditional Chinese Medicine in Anhui Province (reference instrument: Huizhong MQ-2000PT), the comparison between Lanyi AH600 and the reference instruments showed relatively good consistency, while the other 14 hospitals involved four different brands of reference instruments: Arkray, Bio-Rad, DOSOH, and Huizhong, Lanyi AH600 had good consistency with its comparison. The best cut point of the domestic Lanyi AH600 for detecting HbA1c in the diagnosis of diabetes is 6.235%.

Plastic debris in lakes and reservoirs

Plastic debris is thought to be widespread in freshwater ecosystems globally¹. However, a lack of comprehensive and comparable data makes rigorous assessment of its distribution challenging^2,3. Here we present a standardized cross-national survey that assesses the abundance and type of plastic debris (>250 μm) in freshwater ecosystems. We sample surface waters of 38 lakes and reservoirs, distributed across gradients of geographical position and limnological attributes, with the aim to identify factors associated with an increased observation of plastics. We find plastic debris in all studied lakes and reservoirs, suggesting that these ecosystems play a key role in the plastic-pollution cycle. Our results indicate that two types of lakes are particularly vulnerable to plastic contamination: lakes and reservoirs in densely populated and urbanized areas and large lakes and reservoirs with elevated deposition areas, long water-retention times and high levels of anthropogenic influence. Plastic concentrations vary widely among lakes; in the most polluted, concentrations reach or even exceed those reported in the subtropical oceanic gyres, marine areas collecting large amounts of debris⁴. Our findings highlight the importance of including lakes and reservoirs when addressing plastic pollution, in the context of pollution management and for the continued provision of lake ecosystem services.

Macroinvertebrate diversity in relation to limnochemistry in an Austral semi-arid transboundary aquifer region pan system

Pan-wetland systems are one of the world's essential and productive ecosystems and are considered important, unique and complex ecosystems. Anthropogenic activities around the temporary pans in the Khakhea Bray Transboundary Aquifer region are increasingly becoming a big issue of concern as this may affect pan biodiversity. The study specifically aimed to investigate spatial and temporal distributions of metal and nutrient concentrations within the pans in relation to land use, identify potential pollution sources in this water-scarce region, and assess macroinvertebrate diversity and distribution in relation to pan limnochemistry using a combination of multivariate analyses from 10 pans across three seasons. Environmental and anthropogenic variables influence water quality and the distribution of metals concentration in Khakhea-Bray pan systems. Anthropogenic activities such as animal grazing, infrastructure degradation, water withdrawal and littering have resulted in poor water quality within temporary pans, which may strongly influence macroinvertebrate diversity and distribution. Forty-one macroinvertebrate species from 5 insect orders (i.e., Coleoptera, Hemiptera, Odonata, Ephemeroptera, Diptera), Crustacea and Mollusca were identified. Significant differences were observed across the seasons for macroinvertebrate taxa, with high and low species richness being observed in autumn and winter, respectively. Water (i.e., temperature, dissolved oxygen, pH, salinity, conductivity), physical (i.e., stone composition) and sediment (i.e., sulphur, sodium) parameters were found to have a significant impact on the macroinvertebrate communities. Therefore, understanding the relationships between macroinvertebrates and their environment is crucial in understanding how the ecosystem taxa are structured and is vital for informing conservation managers on how to properly manage and protect these systems from further degradation.

The Global Trend of Microplastic Research in Freshwater Ecosystems

The study of microplastics and their impact on aquatic ecosystems has received increasing attention in recent years. Drawing from an analysis of 814 papers related to microplastics published between 2013 and 2022 in the Web of Science Core Repository, this paper explores trends, focal points, and national collaborations in freshwater microplastics research, providing valuable insights for future studies. The findings reveal three distinct stages of microplastics: nascent development (2013-2015), slow rise (2016-2018), and rapid development (2019-2022). Over time, the focus of research has shifted from "surface", "effect", "microplastic pollution", and "tributary" to "toxicity", "species", "organism", "threat", "risk", and "ingestion". While international cooperation has become more prevalent, the extent of collaboration remains limited, mostly concentrated among English-speaking countries or English and Spanish/Portuguese-speaking countries. Future research directions should encompass the bi-directional relationship between microplastics and watershed ecosystems, incorporating chemical and toxicological approaches. Long-term monitoring efforts are crucial to assessing the sustained impacts of microplastics.

Multiple anthropogenic stressors influence the taxonomic and functional homogenization of macroinvertebrate communities on the mainstream of an urban-agricultural river in China

Biodiversity loss is caused by intensive human activities and threatens human well-being. However, less is known about how the combined effects of multiple stressors on the diversity of internal (alpha diversity) and multidimensional (beta diversity) communities. Here, we conducted a long-term experiment to quantify the contribution of environmental stressors (including water quality, land use, climate factors, and hydrological regimes) to macroinvertebrate communities alpha and beta diversity in the mainstream of the Songhua River, the third largest river in China, from 2012 to 2019. Our results demonstrated that the alpha and beta diversity indices showed a decline during the study period, with the dissimilarity in community composition between sites decreasing significantly, especially in the impacted river sections (upper and midstream). Despite overall improvement in water quality after management intervention, multiple human-caused stressors still have led to biotic homogenization of macroinvertebrate communities in terms of both taxonomic and functional diversities in the past decade. Our study revealed the increased human land use explained an important portion of the variation of diversities, further indirectly promoting biotic homogenization by changing the physical and chemical factors of water quality, ultimately altering assemblage ecological processes. Furthermore, the facets of diversity have distinct response mechanisms to stressors, providing complementary information from the perspective of taxonomy and function to better reflect the ecological changes of communities. Environmental filtering determined taxonomic beta diversity, and functional beta diversity was driven by the joint efforts of stressors and spatial processes. Finally, we proposed that traditional water quality monitoring alone cannot fully reveal the status of river ecological environment protection, and more importantly, we should explore the continuous changes in biodiversity over the long term. Meanwhile, our results also highlight timely control of nutrient input and unreasonable expansion of land use can better curb the ecological degradation of rivers and promote the healthy and sustainable development of floodplain ecosystems.

[The performance of digital chest radiographs in the detection and diagnosis of pulmonary nodules and the consistency among readers]

Objective: To investigate the detection and diagnostic efficacy of chest radiographs for ≤30 mm pulmonary nodules and the factors affecting them, and to compare the level of consistency among readers. Methods: A total of 43 patients with asymptomatic pulmonary nodules who consulted in Cancer Hospital, Chinese Academy of Medical Sciences from 2012 to 2014 and had chest CT and X-ray chest radiographs during the same period were retrospectively selected, and one nodule ≤30 mm was visible on chest CT images in the whole group (total 43 nodules in the whole group). One senior radiologist with more than 20 years of experience in imaging diagnosis reviewed CT images and recording the size, morphology, location, and density of nodules was selected retrospectively. Six radiologists with different levels of experience (2 residents, 2 attending physicians and 2 associate chief physicians independently reviewed the chest images and recorded the time of review, nodule detection, and diagnostic opinion. The CT imaging characteristics of detected and undetected nodules on X images were compared, and the factors affecting the detection of nodules on X-ray images were analyzed. Detection sensitivity and diagnosis accuracy rate of 6 radiologists were calculated, and the level of consistency among them was compared to analyze the influence of radiologists' seniority and reading time on the diagnosis results. Results: The number of nodules detected by all 6 radiologists was 17, with a sensitivity of detection of 39.5%(17/43). The number of nodules detected by ≥5, ≥4, ≥3, ≥2, and ≥1 physicians was 20, 21, 23, 25, and 28 nodules, respectively, with detection sensitivities of 46.5%, 48.8%, 53.5%, 58.1%, and 65.1%, respectively. Reasons for false-negative result of detection on X-ray images included the size, location, density, and morphology of the nodule. The sensitivity of detecting ≤30 mm, ≤20 mm, ≤15 mm, and ≤10 mm nodules was 46.5%-58.1%, 45.9%-54.1%, 36.0%-44.0%, and 36.4% for the 6 radiologists, respectively; the diagnosis accuracy rate was 19.0%-85.0%, 16.7%-6.5%, 18.2%-80.0%, and 0%-75.0%, respectively. The consistency of nodule detection among 6 doctors was good (Kappa value: 0.629-0.907) and the consistency of diagnostic results among them was moderate or poor (Kappa value: 0.350-0.653). The higher the radiologist's seniority, the shorter the time required to read the images. The reading time and the seniority of the radiologists had no significant influence on the detection and diagnosis results (P>0.05). Conclusions: The ability of radiographs to detect lung nodules ≤30 mm is limited, and the ability to determine the nature of the nodules is not sufficient, and the increase in reading time and seniority of the radiologists will not improve the diagnostic accuracy. X-ray film exam alone is not suitable for lung cancer diagnosis.

SER: An R package to characterize environmental regimes

Environmental regimes (or environmental legacy or historical legacy) are the dynamics of environmental characteristics over a given (either long or short) time period, such as frequency of mean or extreme events and rate of change, which might be absent by using only contemporary variables. We present SER, an R package for estimating environmental regimes for different environmental variables. Using the data included in the package, several examples are shown. SER is suitable for any type of environmental or biotic variables, including nutrient concentration, light, and dissolved oxygen. In addition, by changing the argument "days_bf," it is possible to compute environmental regimes over any time period, such as days, months, or years. Our case study showed that the inclusion of environmental regimes increased the explained variation of temporal β-diversity and its components. Environmental regimes are expected to advance the "environment-community" relationships in ecological studies. They can further be implemented in other subjects such as social science, socioeconomics, and epidemiology.

Dissolved Oxygen and Water Temperature Drive Vertical Spatiotemporal Variation of Phytoplankton Community: Evidence from the Largest Diversion Water Source Area

In order to study the vertical distribution characteristics of phytoplankton in the Danjiangkou Reservoir, the water source of the Middle Route Project of the South-North Water Diversion, seven sampling sites were set up in the Reservoir for quarterly sampling from 2017 to 2019, and water environment surveys were conducted simultaneously. The results showed that 157 species (including varieties) were identified, belonging to 9 phyla and 88 genera. In terms of species richness, Chlorophyta had the largest number of species, accounting for 39.49% of the total species. The Bacillariophyta and Cyanobacteria accounted for 28.03% and 13.38% of the total species, respectively. From the whole Danjiangkou Reservoir, the total phytoplankton abundance varied from 0.09 × 10² to 20.01 × 10⁶ cells/L. In the vertical distribution, phytoplankton were mainly observed in the surface-thermospheric layer (I-II layer) and the bottom layer, while the Shannon-Wiener index showed a trend of gradually decreasing from the I-V layer. The Surfer model analysis showed that there was no significant stratification in the Q site's water temperature (WT) and dissolved oxygen (DO) levels in the water diversion area during the dynamic water diversion process. A canonical correspondence analysis (CCA) showed that DO, WT, pH, electrical conductivity (Cond), chemical oxygen demand (COD_Mn), total phosphorus (TP), ammonia nitrogen (NH₄⁺-N), and total nitrogen (TN) had significant effects on the vertical distribution of phytoplankton (p < 0.05). A partial Mantel analysis showed that the vertical distribution of the phytoplankton community was related to WT, and the phytoplankton community structure at the other sites, except for Heijizui (H) and Langhekou (L), was affected by DO. This study has positive significance for exploring the vertical distribution characteristics of a phytoplankton community in a deep-water dynamic water diversion reservoir.

CircOMA1 modulates cabergoline resistance by downregulating ferroptosis in prolactinoma

PURPOSE

Prolactinomas are one of the most common pituitary neuroendocrine tumors (PitNETs), accounting for approximately 50% of all pituitary tumors. Dopamine agonists are the main treatment for prolactinoma, but a small number of patients are still resistant to pharmacotherapy. Recent discoveries have revealed that ferroptosis is involved in regulating tumor drug resistance. However, the role of ferroptosis in prolactinoma has not been reported. In this study, we aimed to explore the mechanism of a circRNA in ferroptosis in prolactinoma.

METHODS

The expression of circOMA1 in prolactinoma tissues was examined by quantitative reverse transcription PCR (qRT-PCR). The biological function of circOMA1 was evaluated in vitro and in vivo. To explore the role of ferroptosis in prolactinoma, we used qRT-PCR and western blotting. Glutamate-cysteine ligase, modifier subunit (GCLM) was predicted to be a direct target gene of miR-145-5p by bioinformatics analysis, which was confirmed by luciferase reporter assays.

RESULTS

circOMA1 was overexpressed in drug-resistant prolactinoma tissues compared with sensitive prolactinoma samples. We further found that circOMA1 promoted MMQ cells growth in vivo and in vitro. In addition, GCLM was directly targeted by miR-145-5p and indirectly regulated by circOMA1. Importantly, circOMA1 induced ferroptosis resistance through the increased expression of Nrf2, GPX4, and xCT, and circOMA1 attenuated CAB-induced ferroptosis in MMQ cells in vivo and in vitro.

CONCLUSION

The present study demonstrates that circOMA1 attenuates CAB efficacy through ferroptosis resistance and may be a new therapeutic target for the individualized treatment of DA-resistant prolactinoma patients.

[Clinical and chest CT features of immune checkpoint inhibitor-related pneumonitis]

Objective: To explore the clinical and chest computed tomography (CT) features and the outcome of immune checkpoint inhibitor-related pneumonitis (CIP). Methods: Clinical and chest CT data of 38 CIP patients with malignant tumors from the Cancer Hospital, Chinese Academy of Medical Sciences between August 2017 and April 2021 were retrospectively reviewed, and the outcomes of pneumonitis were followed up. Results: The median time from the administration of immune checkpoint inhibitors (ICIs) to the onset of CIP was 72.5 days in 38 patients with CIP, and 22 patients developed CIP within 3 months after the administration of ICIs. The median occurrence time of CIP in 24 lung cancer patients was 54.5 days, earlier than 119.0 days of non-lung cancer patients (P=0.138), with no significant statistical difference. 34 patients (89.5%) were accompanied by symptoms when CIP occurred. The common clinical symptoms were cough (29 cases) and dyspnea (27 cases). The distribution of CIP on chest CT was asymmetric in 31 cases and symmetrical in 7 cases. Among the 24 lung cancer patients, inflammation was mainly distributed ipsilateral to the primary lung cancer site in 16 cases and diffusely distributed throughout the lung in 8 cases. Ground glass opacities (37 cases) and consolidation (30 cases) were the common imaging manifestations, and organizing pneumonia (OP) pattern (15 cases) was the most common pattern. In 30 CIP patients who were followed up for longer than one month, 17 cases had complete absorption (complete absorption group), and 13 cases had partial absorption or kept stable (incomplete absorption group). The median occurrence time of CIP in the complete absorption group was 55 days, shorter than 128 days of the incomplete absorption group (P=0.022). Compared with the incomplete absorption group, there were less consolidation(P=0.010) and CIP were all classified as hypersensitivity pneumonitis (HP) pattern (P=0.004) in the complete absorption group. Conclusions: CIP often occurs within 3 months after ICIs treatment, and the clinical and CT findings are lack of specificity. Radiologic features may have a profound value in predicting the outcome of CIP.

Lake morphological characteristics and climatic factors affect long-term trends of phytoplankton community in the Rotorua Te Arawa lakes, New Zealand during 23 years observation

Monitoring the long-term dynamics of lake phytoplankton can help understand their natural temporal variability, as well as assess potential impacts of interventions aimed at improving lake ecological condition. However, investigating long-term changes in lake ecosystems has received scant attention. In the present study, we analyzed a long-term dataset of phytoplankton communities collected from 1990 to 2013 from eleven of the 12 Rotorua Te Arawa lakes in New Zealand, to explore their responses to changing abiotic conditions. We used a sequential algorithm to examine the likelihood of regime shifts in abiotic and biotic factors during the study period that could be attributable to lake interventions. Our analysis suggests that lake interventions have improved the abiotic factors, whereas the response of biotic factors was less clear. Total phosphorus levels were implicated in the decline in lake condition, including in two lakes subject to lake interventions, and in four control lakes. Both abiotic and biotic factors showed diverse trends (e.g., increase, decrease or no change), and abiotic factors had more regime shifts than biotic factors. Shifts in biotic indices also displayed time lags to shifts in abiotic factors. Long-term responses of abiotic and biotic factors were also influenced by lake morphological characteristics and climatic variables. This latter finding underscores the importance of considering lake morphological characteristics and climate changes when planning management practices. A sound understanding of resilience and threshold of phytoplankton shifts to environmental changes are needed to assess the effectiveness of previous management strategies and prioritize the future conservation efforts toward water quality goals.

How do multidimensional traits of dominant diatom Aulacoseira respond to abiotic and biotic factors in a river delta system?

Trait-based approaches are being increasingly applied in ecology, and the influence of individual-level trait variation on communities and species has been demonstrated. However, the responses of individual trait variation to environmental changes remain to be explored. To examine the indicating functions of multidimensional traits, individual-level measurements of the dominant diatom genus Aulacoseira Thwaites in the Pearl River Delta were performed, and corresponding responses of three trait indices (trait richness, trait evenness, and trait dispersion) to abiotic and biotic factors were examined. Our results indicated that the three individual trait diversity indices were regulated by different factors. Trait richness was only significantly affected by abiotic factors (temperature), while trait evenness and trait dispersion were regulated by both abiotic and biotic factors. In addition, the direct influence of abiotic factors was more significant than that of biotic factors, implying that the multidimensional trait variation of Aulacoseira was more responsive to environmental changes than to interspecific interactions. Therefore, the multidimensional trait variation of Aulacoseira could be used as an effective indicator to track environmental changes. Our study elucidated the mechanisms relating individual-level trait variation to phytoplankton community dynamics; this could improve our ability to forecast changes in ecosystem properties across environmental gradients.

Exploring the Associations between Alzheimer's Disease and GBM Mediated by Microglia Based on Network Analysis

Previous studies have revealed that there existed epidemic associations between Alzheimer's disease (AD) and many types of tumors, however, the inner biological mechanism connecting these diseases was not clear currently. In this study, we explored the transcriptome associations between AD and glioblastoma multiforme (GBM) that both originate in the brain, using microglia as a bridge, from gene and network levels. Firstly, we extracted human scRNA sequencing datasets from Gene Expression Omnibus (GEO) database, and identified differentially expressed genes within microglia after cell annotation. It was observed that there were 11 common genes shared by AD and GBM dys-regulated genes. Next, we utilized DIAMOnD and Flow Centrality algorithms to identify microglia modules and mediating pathways connecting these two diseases based on global network topology. Among these candidate pathways, the mediating genes FURIN and BACE1 (from SPIKN5 to CSNK1A1) were not only related to the formation of amyloid beta plaques that accumulate in the brain of AD patients, but also involved in cancer biology. Furthermore, the biological explorations of mediating pathways connecting AD and GBM modules reveal inflammatory response, lipid metabolism disorder, and cell proliferation terms. Finally, novel signatures for early AD detection as well as risk models for glioma prognosis were identified based on mediating genes involved in these pathways. In conclusion, this study provided a novel network-based strategy for exploring microglia mediation between AD and GBM and identified candidate signatures for disease detection and prognosis.

Distinct indicators of land use and hydrology characterize different aspects of riverine phytoplankton communities

Given the many threats to freshwater biodiversity, we need to be able to resolve which of the multiple stressors present in rivers are most important in driving change. Phytoplankton are a key component of the aquatic ecosystem, their abundance, species richness and functional richness are important indicators of ecosystem health. In this study, spatial variables, physiochemical conditions, water flow alterations and land use patterns were considered as the joint stressors from a lowland rural catchment. A modeling approach combining an ecohydrological model with machine learning was applied. The results implied that land use and flow regime, rather than nutrients, were most important in explaining differences in the phytoplankton community. In particular, the percentage of water body area and medium level residential urban area were key to driving the rising phytoplankton abundance in this rural catchment. The proportion of forest and pasture area were the leading factors controlling the variations of species richness. In this case deciduous forest cover affected the species richness in a positive way, while, pasture share had a negative effect. Indicators of hydrological alteration were found to be the best predictors for the differences in functional richness. This integrated model framework was found to be suitable for analysis of complex environmental conditions in river basin management. A key message would be the significance of forest area preservation and ecohydrological restoration in maintaining both phytoplankton richness and their functional role in river ecosystems.

Understanding the relative roles of local environmental, geo-climatic and spatial factors for taxonomic, functional and phylogenetic β-diversity of stream fishes in a large basin, Northeast China

The primary objective of this study was to determine the relative roles of local environmental (Local), geo-climatic (Geo), and spatial (Spatial) factors to taxonomic, functional, and phylogenetic β-diversity of stream fish in a large basin in Northeast China. We quantified the current biodiversity patterns of fish communities in the Hun-Tai River using β-diversity. We assessed (i) corresponding contributions of turnover and nestedness within the taxonomic, functional, and phylogenetic β-diversity of fishes; (ii) correlations among β-diversity facets (i.e., taxonomic, functional, and phylogenetic facets); (iii) relative contributions of Local, Geo, and Spatial factors to β-diversity. We collected fish communities from 171 sampling sites. Mantel tests were used to examine the correlation of three facets of β-diversity and their components (i.e., total, nestedness, and turnover). Distance-based redundancy analysis and variation partitioning assess the relative contributions of Local, Geo, and Spatial factors to β-diversity. We found that turnover is the main driving mechanism for β-diversity in fish. Among the facets of β-diversity, taxonomic and phylogenetic facets have strong ecological information association. Spatial factors have a general contribution to various facets of β-diversity and its components. From aspects of fish β-diversity conservation, connectivity and habitat heterogeneity need to be maintained in the entire aquatic environment. In addition, protecting taxonomic β-diversity is helpful for maintaining phylogenetic β-diversity.

[Prevalence and risk factors of coronary artery calcification on lung cancer screening with low-dose CT]

Objective: To investigate the prevalence and risk factors of coronary artery calcification (CAC) on lung cancer screening with low-dose computed tomography (LDCT). Methods: A total of 4 989 asymptomatic subjects (2 542 males and 2 447 females) who underwent LDCT lung cancer screening were recruited at Cancer Hospital, Chinese Academy of Medical Sciences from 2014 to 2017. The visual scoring method was used to assess coronary artery calcification score. χ(2) test or independent t-test was used to compare the difference of CAC positive rate among different groups. Multivariate logistic regression was used to analyze risk factors associated with CAC in the study. Results: Of the 4 989 asymptomatic subjects, CAC occurred in 1 018 cases. The positive rate was 20.4%, of which mild, moderate and severe calcification accounted for 86.3%, 11.4% and 2.3%, respectively. Gender, age, BMI, education level, occupation, smoking history, diabetes, hypertension and hyperlipidemia had statistically significant differences in CAC positive rates among groups. Multivariate logistic regression analysis showed that gender, age, diabetes, hypertension, hyperlipidemia and smoking history were risk factors for CAC. Age, diabetes, hypertension and smoking history were statistically significant risk factors between the mild and moderate CAC group. A total of 1 730 coronary arteries in 1 018 CAC positive cases had calcification, CAC positive rate of left anterior descending was the highest(51.3%); 568 cases (55.8%) were single vessel calcification, 450 cases (44.2%) were multiple vessel calcification. Conclusions: LDCT can be used for the 'one-stop' early detection of lung cancer and coronary atherosclerosis. Gender, age, diabetes, hypertension, hyperlipidemia and smoking are related risk factors for coronary atherosclerosis.

Spatial Factors Outperform Local Environmental and Geo-Climatic Variables in Structuring Multiple Facets of Stream Macroinvertebrates' β-Diversity

Simple Summary

One of the key targets of community ecology and biogeography concerns revealing the variability and underlying drivers of biodiversity. Most current studies understand biodiversity based on taxonomic information alone. Our study was based on macroinvertebrates from 179 stream sampling sites in the Hun-Tai River Basin in Northeastern China. The correlation of different facets of β-diversity was compared while revealing the relative contribution of multiple abiotic factors (i.e., local environmental, geo-climatic, and spatial factors) to shaping β-diversity based on taxonomic, functional, and phylogenetic information. The results showed that functional β-diversity provides important complementary information to taxonomic and phylogenetic β-diversity. Moreover, spatial factors outperform local environmental and geo-climatic variables in structuring multiple facets of stream macroinvertebrates’ β-diversity. Our study provides guidance for future conservation studies of watershed biodiversity, as well as implications for future studies of β-diversity.

Abstract

One of the key targets of community ecology and biogeography concerns revealing the variability and underlying drivers of biodiversity. Most current studies understand biodiversity based on taxonomic information alone, but few studies have shown the relative contributions of multiple abiotic factors in shaping biodiversity based on taxonomic, functional, and phylogenetic information. We collected 179 samples of macroinvertebrates in the Hun-Tai River Basin. We validated the complementarity between the three facets and components of β-diversity using the Mantel test. Distance-based redundancy analysis and variance partitioning were applied to explore the comparative importance of local environmental, geo-climatic, and spatial factors on each facet and component of β-diversity. Our study found that taxonomic and phylogenetic total β-diversity was mainly forced by turnover, while functional total β-diversity was largely contributed by nestedness. There is a strong correlation between taxonomic and phylogenetic β-diversity. However, the correlations of functional with both taxonomic and phylogenetic β-diversity were relatively weak. The findings of variation partitioning suggested that distinct facets and components of macroinvertebrates’ β-diversity were impacted by abiotic factors to varying degrees. The contribution of spatial factors was greater than that of the local environment and geo-climatic factors for taxonomic, functional, and phylogenetic β-diversity. Thus, studying different facets and components of β-diversity allows a clearer comprehension of the influence of abiotic factors on diversity patterns. Therefore, future research should investigate patterns and mechanisms of β-diversity from taxonomic, functional, and phylogenetic perspectives.

[The influence of CT acquisition and reconstruction parameters on the stability of radiomic features of pure ground-glass nodules]

Objective: To investigate the influence of CT reconstruction algorithm, radiation dose, and contrast agent on the stability of radiomic features of pure ground-glass density pulmonary nodules. Methods: A total of 50 pure ground-glass density pulmonary nodules in 35 patients were prospectively selected from Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College in 2018. After reconstructing the original image of the same patient's pulmonary nodules, six sequences of different parameters were obtained. ITK-SNAP software was used to segment different sequences of pure ground-glass density pulmonary nodules. All scanning data were extracted by A. K. software. The radiomic features with good retest reliability were selected by the intraclass correlation coefficient. The statistical software of R language was used to analyze the characteristic parameters. All the radiomic feature values of different sequences were paired and compared. The number of radiomic features changed by acquisition and reconstruction parameters was counted. The influence of different parameters on the reproducibility of pure ground-glass density pulmonary nodules was compared. Results: A total of 391 radiomic features were extracted from 50 cases of pure ground-glass density pulmonary nodules. 320 features with an intraclass correlation coefficient greater than 0.75 were selected for further analysis. By changing the three parameters of CT reconstruction algorithm, radiation dose, and contrast agent simultaneously, the changed radiomic features of the pure ground-glass density pulmonary nodules reach 60.9% (195/320), including 6.7% (1/15) morphological feature, 100.0% (40/40) histogram features, and 58.1% (154/265) texture features. When only one parameter was changed (keeping the other two parameters unchanged), changing the CT reconstruction algorithm, radiation dose, and contrast agent respectively, the changed radiomic features of pure ground-glass density pulmonary nodules were 10.6% (34/320), 30.9% (99/320) and 50.6% (162/320), the difference was statistically significant (P<0.05). When the radiation dose and contrast agent were changed, the radiomic features obtained by the FBP reconstruction algorithm had smaller changes than the features obtained by the 50% ASiR-V algorithm (P=0.001). Conclusions: CT reconstruction algorithm, radiation dose, and contrast agent will affect the radiomic features of pure ground-glass density pulmonary nodules. The contrast agent has the most significant influence on the radiomic features, followed by radiation dose and CT reconstruction algorithm minimum. Compared with morphological features, histogram features and texture features are more likely to be affected by CT reconstruction algorithms, radiation doses, and contrast agents. Compared with the 50% ASiR-V algorithm, the radiomic features obtained by the FBP reconstruction algorithm are less affected by the radiation dose and contrast agent. The influence of these parameters should be fully considered in the radiomic analysis.

Differential uptake of nitrogen forms by two herbs in the Gurbantunggut desert, Central Asia

Understanding how plants adjust their requirements for different N forms can help elucidate plant coexistence strategies in N-limited desert ecosystems. To understand the mechanisms involved, we investigated whether two desert herbs can directly absorb dissolved organic nitrogen (N) and tested whether the patterns changed over different growth stages. Two dominant herbaceous species, Astragalus arpilobus and Arnebia decumbens, from the southern edge of the Gurbantunggut desert, China, were selected. Short-term (24 h) ¹⁵ N-labelled tracer (¹⁵ N-NO₃ , ¹⁵ N-NH₄ , 2-¹³ C-¹⁵ N-Glycine) treatments were conducted at two soil depths (0-5 cm and 5-15 cm) in the season of rapid growth (June) and in the peak biomass season (July). Enrichment in ¹³ C and ¹⁵ N was assessed in the two species receiving glycine. The ratio ¹³ C:¹⁵ N was 0.21-1.39 at the 24-h harvest, suggesting that approximately 10.5-69.5% of glycine had been absorbed. The amount of absorbed ¹⁵ N was significantly affected by species, month, soil depth and N form. The two species absorbed most ¹⁵ N from the 0-5 cm soil layer, and the absorption rate in July was higher than that in June. The absorption of ¹⁵ N-NO₃ and ¹⁵ N-NH₄ was significantly higher than that of 2-¹³ C-¹⁵ N-Glycine. The results indicate that these herbs could use amino acids in the N-deficient desert ecosystem. The two co-existing species used different forms of inorganic N for their requirements and maintained a specific preference throughout various growth stages.

Visible imaging system with changeable field of view on the HL-2A tokamak

A new visible imaging system characterizing a flexible optical design and delivering high resolution frames is established on the HL-2A tokamak. It features a modular configuration, consisting of a front-end imaging lens, a set of bilateral telecentric relay lenses, and a camera. To avoid the effects of plasma radiation (x and gamma-rays) and magnetic field variation on the camera, it should be away from the coils. Therefore, the length of the relay lenses determines the total size of the imaging system. The main feature of this imaging system is to realize the variation of field of view (FOV) by interchanging the front-end prime lenses or by using a zoom lens directly rather than designing the optical system afresh, which lowers the cost drastically. The primary purpose of varying FOV is to enrich the versatility of this system, i.e., focusing on a narrow FOV such as gas puff imaging or a wide FOV such as the plasma cross sections. During the HL-2A experiments, this visible imaging system is used to provide high quality pictures of the plasma-wall interaction, divertor detachment, pellet injections, and so on. The frames confirmed that a strong radiation close to the X point is correlated with the completely detached inner target.

[Clinical features and follow-up outcomes of optic nerve injury induced by acute methanol poisoning]

Acute methanol poisoning harms the optic nerve and central nervous system, can cause irreversible damage, even coma or death in severe cases. This article reported four cases of methanol poisoning. 3 patients mistakenly ingested industrial alcohol containing methanol, the most serious patient suffered from coma, vision loss and other symptoms, the blood methanol concentration was 869.3 μg/ml. Another patient was poisoning caused by inhalation of methanol, with symptoms such as total blindness in the right eye and decreased visual acuity in the left eye. After active supportive treatment, 2 patients had partial recovery of visual acuity, and 2 patients had no sequelae. This article discussed the clinical features, treatment and prognosis of optic nerve damage caused by methanol poisoning, in order to raise awareness of this disease.

[Characteristics of the white matter involvement sites on MRI in patients with multiple gliomas]

The retrospective study included 122 cases of multiple glioma and 183 cases of single glioma. Of these, there were 74 males and 48 female with multiple gliomas, aged 18 to 83 (53±13) years, and 104 males and 79 females with single gliomas, aged 10 to 84 (51±14) years. A standard spatial-based lesion analysis method was used for constructing a spatially distributed frequency heatmap of multiple gliomas, to observe the characteristics of their white matter invasion sites. The spatial distribution was more frequent in the subventricular zone, corpus callosum and cingulate gyrus in the multiple glioma group compared to the single glioma group (P<0.001).The white matter areas of multiple gliomas were more extensively involved, with more frequent involvement of the conjoined fibers (corpus callosum, P<0.05) and contact fibers (cingulate, dome, 0.05<P<0.10) areas.The spatial distribution of the brain and the white matter invasion of multiple gliomas have certain site specificity.

Microeukaryotic Community Shifting Along a Lentic-Lotic Continuum

As an important regulator of ecosystem functions in river systems, microeukaryotes play an important role in energy and material conversion, yet little is known about the shift along a lentic-lotic continuum. In this study, the 18S rRNA genes sequencing was used to identify the microeukaryotic communities at 82 sites along a lentic-lotic continuum with the aim of understanding the impact of upstream inlet river on microeukaryotic communities in Baiyang Lake (BYD) and its downstream. Our results showed that the upstream inlet river affected the diversity and community composition of microeukaryotes in BYD and downstream rivers, and environmental variables greatly affected the composition of microeukaryotic community. The community composition in BYD had lower variabilities. Co-occurrence network analysis revealed that the network was non-random and clearly parsed into three modules, and different modules were relatively more abundant to a particular area. As keystone taxa, some nodes of the upstream microeukaryotic network played an important role in structuring network and maintaining the stability of the ecosystem. In BYD and downstream, the microeukaryotic network was highly fragmented, and the loss of keystone taxa would have an adverse impact on the integrity and function of the microeukaryotic community. Microeukaryotes had strong tendencies to co-occur, which may contribute to the stability and resilience of microeukaryotic communities. Overall, these findings extend the current understanding of the diversity and community composition of microeukaryotic along a lentic-lotic continuum.

Small Run-of-River Dams Affect Taxonomic and Functional β-Diversity, Community Assembly Process of Benthic Diatoms

Being increasingly constructed worldwide, dams are a main driver of flow regime change and biodiversity decline. Although small run-of-river dams have exceeded the number of large dams, their impacts on taxonomic and functional β-diversity as well as community assembly process of aquatic organisms have been largely neglected. Ninety sites within twenty three small run-of-river dams in the Xiangxi River were selected, and the hydrological and physicochemical variables for each site were measured. We analyzed the traits and β-diversity of benthic diatoms, and explored the key driving mechanism of benthic diatom community assembly. Our results indicated that the construction of small run-of-river dams could affect the β-diversity of benthic diatoms and the mechanism of community assembly. Specifically, we found that small run-of-river dams could change the relative contribution of nestedness components to the trait-based β-diversity of benthic diatoms, but generally the taxonomy-based β-diversity was relatively higher than the trait-based β-diversity. Furthermore, the community assembly process of benthic diatoms was also affected. In areas affected directly by small run-of-river dams, dispersal assembly was the key mechanism for community assembly. Compared to unregulated habitats, the dispersal assembly process between the impacted and the unregulated habitats has been enhanced. We advocate that this study can be expanded to other organisms (such as macroinvertebrates, phytoplankton, fish) in future to fully understand impacts of small run-of-river dams on biodiversity from a multi-trophic level aspect. Based on our results, we suggest that maintaining genetic and ecological connectivity based on an effective impact assessment in dry seasons is a potential solution to mitigate the impacts of such dams, as key to adaptive management and sustainability.

[Pretreatment evaluation of 18F-FDG PET-CT in extranodal NK/T-cell lymphoma]

Objective: To investigate the clinical value of pretreatment ¹⁸F-fluorodeoxy glucose positron emission tomography/computed tomography (¹⁸F-FDG PET-CT) in extranodal NK/T-cell lymphoma. Methods: Eighty-one patients with pathologically confirmed extranodal NK/T-cell lymphoma and pretreatment with PET-CT scan in Cancer Hospital, Chinese Academy of Medical Sciences from August 2006 to December 2017 were enrolled in the study. The clinical, follow-up and imaging data were analyzed retrospectively. The relationship between maximum standard uptake value (SUV_max) and prognosis were evaluated by Mann-Whitney U test and Spearman rank correlation analysis. Results: Among the 81 patients, 98.8% (80/81) were upper aerodigestive tract (UAT) involved. Lesions at extra-UAT sites were detected in 7 cases, involving parotid gland (n=1), breast (n=1), spleen (n=1), pancreas (n=1), skin and subcutaneous soft tissue (n=1), muscle (n=1), lung (n=2) and bone (n=3). Lymph node involvement were demonstrated in 33 cases. All of the lesions had increased uptake of PET, the median SUV_max was 8.6. PET-CT changed staging in 15 cases, and 12 cases were adjusted treatment methods. 21 cases were changed radiotherapy target because of PET-CT. The 1-, 2-year progression-free survival (PFS) rates were 88.7% and 80.3% while 1-, 2-year overall survival (OS) rates were 97.2% and 94.4% respectively. The median SUV_max of patients with local lymph nodes involvement was significantly higher than those without local lymph nodes involvement (P=0.007). The SUV_max was positively associated with Ann Arbor stage (r=0.366, P=0.001), lactate dehydrogenase (r=0.308, P=0.005) and Ki-67 level (r=0.270, P=0.017). The SUV_max was inversely associated with lymphocyte count (r=-0.324, P=0.003) and hemoglobin content (r=-0.225, P=0.043). Conclusions: Extranodal NK/T-cell lymphoma predominantly occurs in extra-nodal organs, mainly in the upper respiratory and gastrointestinal tracts, with marked FDG-addiction. Compared with conventional imaging, ¹⁸F-FDG PET-CT is sensitive and comprehensive in detecting extra-nodal NK/T-cell lymphoma involvement, assisting in accurate clinical staging and treatment planning. Pretreatment SUV_max is potential for prognosis evaluation since it is correlated with prognostic factors.