A Q-learning method based on coarse-to-fine potential energy surface for locating transition state and reaction pathway

Transition state (TS) on the potential energy surface (PES) plays a key role in determining the kinetics and thermodynamics of chemical reactions. Inspired by the fact that the dynamics of complex systems are always driven by rare but significant transition events, we herein propose a TS search method in accordance with the Q-learning algorithm. Appropriate reward functions are set for a given PES to optimize the reaction pathway through continuous trial and error, and then the TS can be obtained from the optimized reaction pathway. The validity of this Q-learning method with reasonable settings of Q-value table including actions, states, learning rate, greedy rate, discount rate, and so on, is exemplified in 2 two-dimensional potential functions. In the applications of the Q-learning method to two chemical reactions, it is demonstrated that the Q-learning method can predict consistent TS and reaction pathway with those by ab initio calculations. Notably, the PES must be well prepared before using the Q-learning method, and a coarse-to-fine PES scanning scheme is thus introduced to save the computational time while maintaining the accuracy of the Q-learning prediction. This work offers a simple and reliable Q-learning method to search for all possible TS and reaction pathway of a chemical reaction, which may be a new option for effectively exploring the PES in an extensive search manner.

Clinical Outcomes of Sidewall/Parametrial Simultaneous Integrated Boost for Patients with Cervical Cancer

PURPOSE/OBJECTIVE(S)

In the treatment of cervical cancer, simultaneous integrated boost (SIB) is a common technique to deliver increased dose to gross disease in the para-aortic and pelvic nodal basins. However, SIB to the pelvic sidewall/parametria is not well characterized in the literature. We hypothesized that sidewall simultaneous integrated boost (SIB) in the treatment of cervical cancer is associated with acceptable levels of toxicity.

MATERIALS/METHODS

From 1/2009-12/2018, patients who received concurrent chemoradiation with external beam radiation therapy, utilizing a sidewall SIB technique, followed by low dose rate or high dose rate brachytherapy treatment were retrospectively identified. Sidewall SIB was defined as treatment at 2.1-2.4Gy/fraction to the parametria-usually performed for those with disease width >4cm at time of treatment start. Acute and late toxicity grading was defined by the Common Terminology Criteria for Adverse Events Version 5.0. Overall survival (OS), local control, progression-free survival (PFS), and toxicity were analyzed utilizing the Kaplan Meier method. Potential associations between cumulative D2cc for bladder and rectum and time to toxicity were investigated using Cox regression.

RESULTS

Fifty-six patients with IB2-IVB cervical cancer treated with sidewall SIB were identified, with a median follow up of 7.0 years (95% CI: 6.3, 8.3). Patients had a median age of 43 years (range: 26-68); 2 (3.6%) had FIGO stage I, 7 (12.5%) stage II, 46 (82.1%) stage III, and 1 (1.8%) stage IV disease. A majority had squamous cell histology (83.9%). Nearly all patients (96.4%) received concurrent cisplatin chemotherapy. Rates of acute grade ≥3 gastrointestinal (GI), genitourinary (GU), vaginal, and hematologic toxicity were 1.8%, 1.8%, 0%, and 15.9% respectively. Rates of late grade ≥3 GI, GU, and vaginal toxicity were 11.3%, 18.5%, and 11.1% respectively. OS and local control rates at five years were 0.61 (95% CI: 0.46, 0.73) and 0.95 (95% CI: 0.84, 0.98), respectively. Median PFS was 7.8 years (95% CI: 2.4, Not reached). Cumulative D2cc bladder was not significantly associated with time to Grade 2 or greater (HR 1.04, p = 0.33) or Grade 3 or greater (HR 1.02; p = 0.64) GU toxicity. Cumulative D2cc rectum was not significantly associated with time to Grade 2 or greater (HR 1.06, p = 0.06) or Grade 3 or greater (HR 1.08; p = 0.09) GI toxicity.

CONCLUSION

Sidewall SIB is a feasible technique for dose escalation in the treatment of cervical cancer with rates of acute and late toxicity consistent with other reports.

Intracranial Control with Combined Dual Immune-Checkpoint Blockade and SRS for Melanoma and NSCLC Brain Metastases

PURPOSE/OBJECTIVE(S)

It is unknown whether the use of dual immune-checkpoint inhibition (D-ICI) combined with stereotactic radiosurgery (SRS) affects local control of brain metastases (BMs). We sought to characterize the efficacy of SRS and D-ICI in patients with BMs in a large, single-institution cohort.

MATERIALS/METHODS

Patients with melanoma and non-small cell lung cancer (NSCLC) BMs treated with SRS from January 1, 2016 to August 1, 2022 were evaluated. Patients were stratified by treatment with D-ICI versus single ICI (S-ICI). Concurrent ICI was defined as ICI given within four weeks of SRS. Local recurrence (LR), intracranial progression (IP), and overall survival (OS) were estimated using competing risk and Kaplan-Meier analyses. IP included both local and distant intracranial recurrence.

RESULTS

One thousand seven hundred four SRS-treated BMs from 288 patients met inclusion criteria. 55% of patients were symptomatic from their BMs at presentation. Median age, KPS, number of lesions, and SRS courses were 64 (Q1Q3:56-70.5), 90 (80-90), 2 (1-4), and 1 (1-2), respectively. One hundred twenty-eight (44%) melanoma and 160 (56%) NSCLC patients were included. 82 (28.5%), 129 (44.8%), and 77 (26.7%) patients were treated with D-ICI, S-ICI, or SRS alone. Median SRS dose, fractions, and PTV were 20 (Q1Q3:20-25), 1 (1-5), and 0.3cc3 (0.1-1.2). The median follow-up was 14.3 months. One hundred twenty-seven (7.45%) BMs recurred post-SRS and the median time to LR was 4.8 months (Q1Q3:3.0-9.2). On competing risk analysis, LR was significantly reduced with D-ICI (HR: 0.452, p = 0.0024), but not with S-ICI (HR: 0.693, p = 0.0596) compared to SRS alone. The 1-year LR was 3.77% (95% CI = 2.19-6.00), 6.8% (5.19-8.70), and 8.96% (6.48-11.93) with D-ICI, S-ICI, and SRS alone. The median time to IP was 4.1 months (Q1Q3 = 2.9-9.5). On competing risk analysis, IP was significantly reduced with D-ICI (HR = 0.638, p = 0.031), but not with S-ICI (HR = 0.756, p = 0.106) compared to SRS alone. 1-year IP was 40.05% (95% CI = 29.14-50.70), 51.86% (42.78-60.19), and 58.49% (46.30-68.84) with D-ICI, S-ICI, and SRS alone. Concurrent delivery of D-ICI and SRS significantly reduced IP (HR = 0.463, p = 0.0071), whereas other combinations of timing and ICI did not reach significance. Median OS was 11.9 months after SRS. On Kaplan Meier analysis, OS was significantly improved with D-ICI (HR = 0.616, 95% CI = 0.412-0.923, p = 0.019), but not with S-ICI (HR = 0.877, 95% CI = 0.633-1.217, p = 0.433) compared to SRS alone. Hospitalizations (p = 0.021) and immune-related adverse events (irAEs) (p<0.001) were increased with D-ICI. Any grade radiation necrosis (RN) was also increased with D-ICI (p = 0.013), but neurologic adverse events were comparable across cohorts (p = 0.572).

CONCLUSION

D-ICI combined with SRS was associated with improved local control, intracranial control, and overall survival compared to SRS alone, whereas S-ICI was not associated with an improvement in these outcomes. However, D-ICI was also associated with increased risks of irAEs and RN.

HISMD: A Novel Immune Subtyping System for HNSCC

Immune subtyping is an important way to reveal immune heterogeneity, which may contribute to the diversity of the progression and treatment in head and neck squamous cell carcinoma (HNSCC). However, reported immune subtypes mainly focus on levels of immune infiltration and are mostly based on a mono-omics profile. This study aimed to identify a comprehensive immune subtype for HNSCC via multi-omics clustering and build a novel subtype prediction system for clinical application. Data were obtained from The Cancer Genome Atlas database and our independent multicenter cohort. Multi-omics clustering was performed to identify 3 clusters of 499 patients in The Cancer Genome Atlas based on immune-related gene expression and somatic mutations. The immune characteristics and biological features of the obtained clusters were revealed by bioinformatics, and 3 immune subtypes were identified: 1) adaptive immune activation subtype predominantly enriched in T cells, 2) innate immune activation subtype predominantly enriched in macrophages, and 3) immune desert subtype. Subsequently, the clinical implications of each subtype were analyzed per clinical epidemiology. We found that adaptive immune activation showed better survival outcomes and had a similar response to chemotherapy with innate immune activation, whereas immune desert might be relatively resistant to chemotherapy. Moreover, a subtype prediction system was developed by deep learning with whole slide images and named HISMD: HNSCC Immune Subtypes via Multi-omics and Deep Learning. We endowed HISMD with interpretability through image-based key feature extraction. The clinical implications, biological significances, and predictive stability of HISMD were successfully verified by using our independent multicenter cohort data set. In summary, this study revealed the immune heterogeneity of HNSCC and obtained a novel, highly accurate, and interpretable immune subtyping prediction system. For clinical implementation in the future, additional validation and utility studies are warranted.

Machine Learning Prediction of the Exfoliation Energies of Two-Dimension Materials via Data-Driven Approach

Exfoliation energy is one of the fundamental parameters in the science and engineering of two-dimensional (2D) materials. Traditionally, it was obtained via indirect experimental measurement or first-principles calculations, which are very time- and resource-consuming. Herein, we provide an efficient machine learning (ML) method to accurately predict the exfoliation energies for 2D materials. Toward this end, a series of simple descriptors with explicit physical meanings are defined. Regression trees (RT), support vector machines (SVM), multiple linear regression (MLR), and ensemble trees (ET) are compared to develop the most suitable model for the prediction of exfoliation energies. It is shown that the ET model can efficiently predict the exfoliation energies through extensive validations and stability analysis. The influence of the defined features on the exfoliation energies is analyzed by sensitivity analysis to provide novel physical insight into the affecting factors of the exfoliation energies.

Aetiology of tinea capitis in China: A multicentre prospective study

BACKGROUND

Tinea capitis is still common in developing countries, such as China. Its pathogen spectrum varies across regions and changes over time.

OBJECTIVES

This study aimed to clarify the current epidemiological characteristics and pathogen spectrum of tinea capitis in China.

METHODS

A multicentre, prospective descriptive study involving 29 tertiary hospitals in China was conducted. From August 2019 to July 2020, 611 patients with tinea capitis were enrolled. Data concerning demography, risk factors and fungal tests were collected. The pathogens were further identified by morphology or molecular sequencing when necessary in the central laboratory.

RESULTS

Among all enrolled patients, 74.1% of the cases were 2- to 8-year-olds. The children with tinea capitis were mainly boys (56.2%) and more likely to have an animal contact history (57.4% vs. 35.3%, P = 0.012) and zoophilic dermatophyte infection (73.5%). The adults were mainly females (83.3%) and more likely to have anthropophilic agent infection (53.5%). The most common pathogen was zoophilic Microsporum canis (354, 65.2%), followed by anthropophilic Trichophyton violaceum (74, 13.6%). In contrast to the eastern, western and northeastern regions where zoophilic M. canis predominated, anthropophilic T. violaceum predominated in central China (69.2%, P < 0.0001), where the patients had the most tinea at other sites (20.3%) and dermatophytosis contact (25.9%) with the least animal contact (38.8%). Microsporum ferrugineum was the most common anthropophilic agent in the western area, especially in Xinjiang Province.

CONCLUSIONS

Boys aged approximately 5 years were mainly affected. Dermatologists are advised to pay more attention to the different transmission routes and pathogen spectra in different age groups from different regions.

[Effect of splenectomy on the risk of hepatocellular carcinoma development among patients with liver cirrhosis and portal hypertension: a multi-institutional cohort study]

Objective: To identify whether splenectomy for treatment of hypersplenism has any impact on development of hepatocellular carcinoma(HCC) among patients with liver cirrhosis and hepatitis. Methods: Patients who underwent splenectomy for hypersplenism secondary to liver cirrhosis and portal hypertension between January 2008 and December 2012 were included from seven hospitals in China, whereas patients receiving medication treatments for liver cirrhosis and portal hypertension (non-splenectomy) at the same time period among the seven hospitals were included as control groups. In the splenectomy group, all the patients received open or laparoscopic splenectomy with or without pericardial devascularization. In contrast, patients in the control group were treated conservatively for liver cirrhosis and portal hypertension with medicines (non-splenectomy) with no invasive treatments, such as transjugular intrahepatic portosystemic shunt, splenectomy or liver transplantation before HCC development. All the patients were routinely screened for HCC development with abdominal ultrasound, liver function and alpha-fetoprotein every 3 to 6 months. To minimize the selection bias, propensity score matching (PSM) was used to match the baseline data of patients among splenectomy versus non-splenectomy groups. The Kaplan-Meier method was used to calculate the overall survival and cumulative incidence of HCC development, and the Log-rank test was used to compare the survival or disease rates between the two groups. Univariate and Cox proportional hazard regression models were used to analyze the potential risk factors associated with development of HCC. Results: A total of 871 patients with liver cirrhosis and hypertension were included synchronously from 7 tertiary hospitals. Among them, 407 patients had a history of splenectomy for hypersplenism (splenectomy group), whereas 464 patients who received medical treatment but not splenectomy (non-splenectomy group). After PSM,233 pairs of patients were matched in adjusted cohorts. The cumulative incidence of HCC diagnosis at 1,3,5 and 7 years were 1%,6%,7% and 15% in the splenectomy group, which was significantly lower than 1%,6%,15% and 23% in the non-splenectomy group (HR=0.53,95%CI:0.31 to 0.91,P=0.028). On multivariable analysis, splenectomy was independently associated with decreased risk of HCC development (HR=0.55,95%CI:0.32 to 0.95,P=0.031). The cumulative survival rates of all the patients at 1,3,5,and 7 years were 100%,97%,91%,86% in the splenectomy group,which was similar with that of 100%,97%,92%,84% in the non-splenectomy group (P=0.899). In total,49 patients (12.0%) among splenectomy group and 75 patients (16.2%) in non-splenectomy group developed HCC during the study period, respectively. Compared to patients in non-splenectomy group, patients who developed HCC after splenectomy were unlikely to receive curative resection for HCC (12.2% vs. 33.3%,χ²=7.029, P=0.008). Conclusion: Splenectomy for treatment of hypersplenism may decrease the risk of HCC development among patients with liver cirrhosis and portal hypertension.

124 Perceived Quality of End-Of-Life Communication Provided by Healthcare Professionals Among Frail Older Chinese Patients

Introduction

Better communications among the patient, their family, and healthcare providers can enable a shared understanding on patient’s end-of-life (EOL) care preferences. Discussion about death-related issue however has been thought to be taboo among Chinese people. This study aims to explore perceived quality of EOL communication provided by healthcare professionals (HCPs) among frail older Chinese patients.

Method

Frail older patients were recruited from a medical ward of a public hospital for a randomized controlled trial of the effectiveness of a nurse-led advance care planning. Participants completed a baseline questionnaire including the 7-item Quality of Communication (QOC) Questionnaire which measures perceived quality of EOL communication provided by HCPs (0 “The worst or none happened” to 10 “The best”). Bivariate analyses examined associated factors of QOC.

Results

Between December 2018 and January 2020, 105 participants were recruited and have completed the QOC. Their mean age was 80 years old (SD = 7.1), and 74% (n = 78) reported had received some formal education. A total of 95 participants (91%) responded “0” to all the 7 items in QOC (poor QOC group). For individual QOC item, all participants scored “0” in 4 items, 99 scored “0” in Item 1 “Talking about details if you got sicker”, 104 scored “0” in Item 2 “Talking about how long you might have to live”, and 101 scored “0” in Item 7 “Respecting your spiritual or religious beliefs”. Participants with “0” score in QOC reported a significant lower mean level in certainty regarding decision-making in EOL preferences (1.2 ± 1.6 vs. 2.3 ± 1.8, p = 0.039).

Conclusion

Occurrence of talking about EOL care with frail older Chinese patients by HCPs was rare, and the quality of EOL communication associated with decision-making certainty regarding EOL preferences. Training of initiation of EOL discussions and improve communication skills for HCPs is essential. Funding: RGC, HKSAR, China (PolyU14162617H).

Accelerating the optimization of enzyme-catalyzed synthesis conditions via machine learning and reactivity descriptors

Enzyme-catalyzed synthesis reactions are of crucial importance for a wide range of applications. An accurate and rapid selection of optimal synthesis conditions is crucial and challenging for both human knowledge and computer predictions. In this work, a new scenario, which combines a data-driven machine learning (ML) model with reactivity descriptors, is developed to predict the optimal enzyme-catalyzed synthesis conditions and the reaction yield. Fourteen reactivity descriptors in total are constructed to describe 125 reactions (classified into five categories) included in different reaction mechanisms. Nineteen ML models are developed to train the dataset and the Quadratic support vector machine (SVM) model is found to exhibit the best performance. The Quadratic SVM model is then used to predict the optimal reaction conditions, which are subsequently used to obtain the highest yield among 109 200 reaction conditions with different molar ratios of substrates, solvents, water contents, enzyme concentrations and temperatures for each reaction. The proposed protocol should be generally applicable to a diverse range of chemical reactions and provides a black-box evaluation for optimizing the reaction conditions of organic synthesis reactions.

Data-driven machine learning model for the prediction of oxygen vacancy formation energy of metal oxide materials

Metal oxides are widely used in the fields of chemistry, physics and materials science. Oxygen vacancy formation energy is a key parameter to describe the chemical, mechanical, and thermodynamic properties of metal oxides. How to acquire quickly and accurately oxygen vacancy formation energy remains a challenge for both experimental and theoretical researchers. Herein, we propose a machine learning model for the prediction of oxygen vacancy formation energy via data-driven analysis and the definition of simple descriptors. Starting with the database containing oxygen vacancy formation energies for 1750 metal oxides with enough structural diversity, new descriptors that effectively avoid the defects of molecular fingerprints, molecular graphic descriptors and site descriptors are defined. The descriptors have obvious physical meanings and wide practicability. Multiple linear regression analysis is then used to screen important features for machine learning model development, and two strongly associated features are obtained. The selected descriptors are used as input for the training of 21 machine learning models to select and develop the most accurate machine learning model. Finally, it is shown that the least squares support vector regression method exhibits the best performance for accurate prediction of the targeted oxygen vacancy formation energy through systematic error analysis, and the prediction accuracy is also verified by the external dataset. Our work establishes a novel and simple computational approach for accurate prediction of the oxygen vacancy formation energy of metal oxides and highlights the availability of data-driven analysis for metal oxide material research.

Prediction of band gap for 2D hybrid organic–inorganic perovskites by using machine learning through molecular graphics descriptors

Molecular graphics descriptors are used to predict the band gap of 2D perovskites.

[Analysis of treatment response and prognostic factors of T-LBL patients treated with pediatric-like ALL therapy following HSCT]

目的

探讨经急性淋巴细胞白血病（ALL）儿童方案治疗达到完全缓解（CR）和部分缓解（PR）的T淋巴母细胞淋巴瘤（T-LBL）患者应用造血干细胞移植巩固治疗的疗效及预后因素。

方法

收集2013年1月至2017年1月于唐都医院血液病中心接受治疗的T-LBL患者的临床资料，将达到CR或PR的患者纳入研究，进行回顾性分析。

结果

①48例患者接受了ALL儿童方案治疗，经2个疗程的诱导化疗后39例达CR，9例达PR。其中接受自体造血干细胞移植（auto-HSCT）者14例，接受异基因造血干细胞移植（allo-HSCT）者7例，21例患者移植后造血功能均顺利重建。②中位随访时间31（9～16）个月。3年总生存（OS）率为61.0%（95% CI 53.7%～68.3%），3年无进展生存（PFS）率为54.8%（95% CI 47.1%～62.2%）。③移植组和未移植组3年OS率分别为84.7%和42.8%（P＝0.006），两组3年PFS率分别为75.4%和38.9%（P＝0.004）。④auto-HSCT组与allo-HSCT组患者的OS率、PFS率差异均无统计学意义（P值分别为0.320、0.597）。⑤骨髓侵犯、未接受造血干细胞移植是影响患者长期预后的独立危险因素［ HR＝5.804（95% CI 1.140～29.549），P＝0.034；HR＝5.871（95% CI 1.711～20.140），P＝0.005］。

结论

ALL儿童方案化疗序贯造血干细胞移植治疗T-LBL疗效确切，安全性好。auto-HSCT与allo-HSCT患者的OS率及PFS率差异均无统计学意义。骨髓侵犯、未接受造血干细胞移植是影响T-LBL患者长期预后的独立危险因素。

[Surveillance of Oncomelania hupensis distribution and water levels in Gaoyou sections of the eastern route project of the South-to-North Water Diversion Project following operation of the project]

OBJECTIVE

To understand the distribution of Oncomelania hupensis snails and changes of water levels in Gaoyou sections of the Li Canal following the operation of the eastern route project of the South-to-North Water Diversion Project.

METHODS

The Oncomelania snails were monitored in the river banks and water bodies of Gaoyou sections of the Li Canal by means of systematic sampling combined with environmental sampling as well as collection of the floaters from 2014 to 2019, and the water levels were collected in Gaoyou sections of the Li Canal at the typical hydrological year before the operation of the eastern route project of the South-to-North Water Diversion Project and during the period between 2016 and 2019.

RESULTS

A total area of 235.42 hm² were investigated and a total of 75.8 kg floaters were collected in Gaoyou sections of the Li Canal from 2014 to 2019; however, no snails were found. The water level in Gaoyou sections of the Li Canal was predominantly high in the flood season and low in the dry season before the operation of the eastern route project of the South-to-North Water Diversion Project, and the water level was elevated in the dry season and relatively low in the flood season after the operation of the project.

CONCLUSIONS

Following the operation of the eastern route project of the South-to-North Water Diversion Project, the original river bank that is characterized by "land in winter and water in summer" has changed in Gaoyou sections of the Li Canal, which is not favorable for snail breeding.

Retirement planning: the perceptions of pre-retirement nurses within different hospitals in China

AIM

This study explored the perceptions of senior Chinese nurses working in different hospital types, about retirement planning; and compared the results from two hospitals.

BACKGROUND

A recent review indicates that nurses with inadequate retirement planning could be faced with a retirement crisis. In China, hospitals are classified into different levels, and salaries, job satisfaction and the turnover of nurses varies among these levels. These factors may also influence nurses' perceptions of retirement planning.

METHODS

In a descriptive, qualitative design, 27 semi-structured individual interviews were conducted with nurses who were between 50 and 60 years old and recruited from two hospitals in China from April to September 2018. The interviews were transcribed and analysed thematically.

FINDINGS

Four main themes emerged from the interviews, namely, the understanding of pre-retirement nurses of retirement planning, the attitudes of pre-retirement nurses towards retirement planning, factors influencing nurses' retirement planning and the retirement planning activity of nurses. Most nurses participating in this study did not know much about retirement planning, but they all agreed on its importance. We identified the influencing factors of retirement planning and several differences regarding the perceptions of nurses about retirement planning in different hospitals.

CONCLUSION

In this cohort of nurses, planning for a good retirement was thought to be important; however, their readiness for retirement and the influences around planning for retirement were varied in type and scope.

IMPLICATIONS FOR POLICY

Governments and employing hospitals should develop reasonable measures and policies to support nurses in their understanding of the benefits of retirement planning and help them to prepare for retirement. Information about retirement planning should be made available and options for planning explained. Any systematic hurdles to retirement planning should be mitigated or eliminated.

[Efficacy and safety study of microsurgical varicocelectomy in the treatment of non-obstructive azoospermia with varicocele]

Objective: To discuss the efficacy and safety of subinguinal microsurgical varicocelectomy in the treatment of non-obstructive azoospermia (NOA) with varicocele. Methods: The clinical data of 141 patients with NOA and varicocele who underwent subinguinal microsurgical varicocelectomy from March 2015 to June 2017 in Shanghai General Hospital was collected.One hundred and ten patients suffered from varicocele on the left side, 1 on the right side, and the rest (30 cases) were bilateral varicocele. Grade Ⅰ varicocele were found on 7 sides (the right and left side was count respectively), grade Ⅱ on 121 sides, and grade Ⅲ on 43 sides. Sperm analysis, pregnancy rate and complications were recorded after at least 6 months since operation. Results: Eleven cases were lost during the follow-up. Eighteen of the remaining 130 NOA patients processed successful sperm retrieval in post-operative semen analysis (18/130, 13.8%). Six couples(6/130, 4.6%) succeeded in natural pregnancy. Five couples (5/130, 3.8%)underwent successful pregnancy following with intracytoplasmic sperm injection(ICSI). Twenty-six out of the remaining 112 patients underwent the micro dissection testicular sperm extraction (micro-TESE), and 4 patients got a successful sperm retrieval (4/26, 15.4%). Among them, 2 couples had successful pregnancy with ICSI. Totally 2 cases of postoperative infection of incision were found. Conclusions: Microsurgical varicocelectomy had a beneficial effect on sperm quality of patients suffered from NOA with varicocele to some extent, even leading to unassisted pregnancy or avoiding micro-TESE before ICSI. Microsurgical varicocelectomy could be applied in the treatment of NOA with varicocele.

Functional Outcome after Treatment of Aggressive Tumours in the Distal Radius: Comparison between Reconstruction using Proximal Fibular Graft and Wrist Fusion

Introduction: Restoration of a functional hand is the ultimate goal following a distal radius tumour resection. The early outcomes of mobile wrist reconstruction are satisfactory; however, long-term results are unpredictable due to late wrist instability and degenerative arthritis. Our aim is to compare mobile wrist reconstruction with wrist fusion (pan-carpal fusion) in our cohort of patients.

Materials and Methods: A retrospective cohort study was performed for functional outcomes of all patients who underwent resection for distal radius tumour and treated with either fusion or reconstruction of the wrist in a single institution from years 2000-2013 with a minimum of three years follow-up.

Results: Eleven patients were included in the study, six of whom had wrist reconstruction with proximal fibula graft and the remaining five wrist fusion, with a mean follow-up of 6.3 years. The mean Musculoskeletal Tumour Society (MSTS) score was 82.78%, ranging from 70% to 93.3%. Average grip strength compared to the normal contralateral hand was 60.0% for total wrist fusion, which was better than wrist reconstruction with 58.07%. There was no difference in the functional outcome between fusion and mobile reconstruction in our study. Osteoarthritis changes and subluxation of the wrist joint were the most common findings in the long-term follow-up for this group.

Conclusion: There was no difference in the functional outcome of the long-term follow-up between the two groups.

[Premature outflow tract ventricular contraction combined with complete bundle branch block: the characteristic electrocardiographic and ablation target potential features]

Objective: To explore the characteristics of electrocardiogram(ECG) and target potential features of premature ventricular contraction (PVC) in patients with complete left/right bundle branch block (CL/RBBB) and compare with those without CL/RBBB. Methods: A retrospective analysis was done in 8 outflow tract PVC patients with CL/RBBB, who successfully underwent radiofrequency ablation from August 2009 to June 2017. According to the bundle branch block chamber, patients were divided into the complete right bundle branch block (CRBBB) group (n=4) and the complete left bundle branch block (CLBBB) group (n=4). The control group were those who successfully underwent ablation at the same position as the above two groups but without CL/RBBB. The characteristics of ECG and target potential features were compared among groups. Results: One case in the CRBBB group was successfully ablated in the great cardiac vein with precordial R/S>1 transition at V(1) and one case in the CLBBB group was successfully ablated in the right coronary cusp with precordial R/S>1 transition at V(2), while other 6 cases were all with precordial R/S>1 transition at lead V(4). Precordial R/S>1 transition was not later than sinus rhythm (SR) in the CLBBB group. No statistical difference was found in the QRS complex duration between SR and PVC in the CL/RBBB patients [(134.38±23.80)ms vs (156.75±25.93)ms, P>0.05], while statistical difference was shown in the control group [(92.63±5.76)ms vs (140.25±15.97)ms, P<0.05]. Conclusion: Bundle branch block can lead to misjudgment of PVC origin with CL/RBBB during sinus rhythm, thus the origin chamber of the PVC should be determined according to the mapping and ablation result.

Early spectra of the gravitational wave source GW170817: Evolution of a neutron star merger

On 17 August 2017, Swope Supernova Survey 2017a (SSS17a) was discovered as the optical counterpart of the binary neutron star gravitational wave event GW170817. We report time-series spectroscopy of SSS17a from 11.75 hours until 8.5 days after the merger. Over the first hour of observations, the ejecta rapidly expanded and cooled. Applying blackbody fits to the spectra, we measured the photosphere cooling from [Formula: see text] to [Formula: see text] kelvin, and determined a photospheric velocity of roughly 30% of the speed of light. The spectra of SSS17a began displaying broad features after 1.46 days and evolved qualitatively over each subsequent day, with distinct blue (early-time) and red (late-time) components. The late-time component is consistent with theoretical models of r-process-enriched neutron star ejecta, whereas the blue component requires high-velocity, lanthanide-free material.

Light curves of the neutron star merger GW170817/SSS17a: Implications for r-process nucleosynthesis

On 17 August 2017, gravitational waves (GWs) were detected from a binary neutron star merger, GW170817, along with a coincident short gamma-ray burst, GRB 170817A. An optical transient source, Swope Supernova Survey 17a (SSS17a), was subsequently identified as the counterpart of this event. We present ultraviolet, optical, and infrared light curves of SSS17a extending from 10.9 hours to 18 days postmerger. We constrain the radioactively powered transient resulting from the ejection of neutron-rich material. The fast rise of the light curves, subsequent decay, and rapid color evolution are consistent with multiple ejecta components of differing lanthanide abundance. The late-time light curve indicates that SSS17a produced at least ~0.05 solar masses of heavy elements, demonstrating that neutron star mergers play a role in rapid neutron capture (r-process) nucleosynthesis in the universe.

Tacrolimus protects vascular endothelial cells from injuries caused by Ox-LDL by regulating endoplasmic reticulum stress

OBJECTIVE

To study the protective effect of tacrolimus on endothelial cells under the action of oxidized low-density lipoprotein (Ox-LDL), and to explore the mechanism of tacrolimus in protecting endothelial cells.

MATERIALS AND METHODS

Human umbilical vein endothelial cells (HUVEC) were used and they were divided into the blank group, tacrolimus group, ox-LDL injury group, and tacrolimus + ox-LDL (tacrolimus treatment) group, for treatment. The cell viability was detected via methyl thiazolyl tetrazolium (MTT) assay; the cytotoxic response was detected via lactate dehydrogenase (LDH) release assay, and the proportion of apoptotic cells was detected via flow cytometry. Moreover, the releases of superoxide dismutase (SOD), reactive oxygen species (ROS), were detected, and the expression levels of apoptosis-related molecules, and the endoplasmic reticulum stress (ERS)-related molecules were detected via polymerase chain reaction (PCR) and Western blotting.

RESULTS

Ox-LDL could significantly reduce the viability of endothelial cells, increase the cytotoxicity and induce the apoptosis, while tacrolimus could effectively reduce such a toxic effect in a dose-dependent manner (p<0.05). Also, tacrolimus could significantly reduce the oxidative stress response of cells caused by ox-LDL and the expressions of ERS-related proteins, and protect the cells from oxidative stress injury (p<0.05).

CONCLUSIONS

Tacrolimus regulates ERS of endothelial cells to reduce ox-LDL-induced injuries.

[Efficacy and safety of Rivaroxaban anticoagulant therapy in the treatment of atrial fibrillation cryoablation]

Objective: To observe the efficacy and safety of the novel oral anticoagulant Rivaroxaban for anticoagulation therapy in patients with nonvalvular atrial fibrillation (AF) during cryoablation. Methods: A total of 137 AF patients from October 2013 to December 2016 underwent cryoablation were divided into two groups according to the application of anticoagulant drugs: Rivaroxaban group (65 cases) and Heparin group (72 cases). Rivaroxaban group: oral administration of Rivaroxaban 20 mg, once a day, was started 3 days before the cryoablation, no anticoagulant was additionally added during cryoablation, the activated clotting time (ACT) was measured, and oral administration of Rivaroxaban was continued for 3 months after cryoablation. Heparin group: oral administration of Rivaroxaban 20 mg, once a day, was stopped 24 hours before the cryoablation, heparin (100 U/kg) anticoagulation was given during cryoablation, ACT was controlled between 250 and 300 seconds, and oral administration of Rivaroxaban was continued for 3 months after cryoablation. The ACT results, the incidence of bleeding and thromboembolic events between the two groups were compared. Results: The ACT result between the two groups were with statistically significance[(110±16) vs (323±61) seconds, P=0.000)]. The bleeding events for Rivaroxaban group were two cases of local hematoma of the femoral vein puncture site, with the incidence rate of 3.1%(2/65); Heparin group were two cases of local hematoma of the femoral vein puncture site, and one case of epistaxis, with the incidence rate of 4.2%(3/72), with no statistical significance(P=0.549) between the two groups. No thromboembolic event occurred in the Rivaroxaban group, one cerebellar thromboembolic event occurred in the Heparin group during anticoagulant bridging phase after cryoablation. Conclusion: Rivaroxaban is safe and effective for anticoagulation therapy in patients with atrial fibrillation cryoablation.

[Correlation between anatomical factors of spermatic vessels and varicocele]

Objective: To analyze the correlation between anatomy of spermatic vessels and varicocele, providing reference for the preoperative assessment and treatment of varicocele. Methods: A total of 156 patients who underwent microsurgical left subinguinal varicocelectomy at Shanghai General Hospital between May 2015 and July 2016 were included in this study. The severity of varicocele and number of spermatic vessels detected in operations were recorded. According to the number of internal spermatic arteries (ISAs), the patients were divided into three groups: single-ISA group (55 cases), double-ISAs group (63 cases) and multi-ISAs group (38 cases), to analyze the correlation among spermatic vessels and to compare varicocele grade, the volume of testes, the parameter of semen analysis, serum reproductive hormone, surgery time, and hospital stay among the three groups. Results: The number of ISAs was positively correlated with the ipsilateral internal spermatic veins (ISVs) (r=0.210; P=0.008)and lymphatic vessels (r=0.224; P=0.005); the number of lymphatic vessels was positively correlated with the ipsilateral gubernacular veins (r=0.172; P=0.032)and ISVs (r=0.296; P=0.000) . The number of ISVs in the multi-ISAs group (10.58±4.28) was significantly larger than that in the single-ISA group (8.22±3.10, P=0.003). The number of lymphatic vessels in the multi-ISAs group(4.11±1.90)was also significantly larger than that in the double-ISA group(3.76±1.40, P=0.020) and the single-ISA group(3.13±1.52, P=0.007). The number of ISVs in grade 2 varicocele patients (9.74±3.90) was significantly higher than that in grade 3 varicocele patients (8.33±3.10, P=0.013). No significant differences in varicocele grade, change of pre- and post-operative semen analysis, serum reproductive hormone, the volume of ipsilateral testes, surgery time, and hospital stay were observed among the three groups. Conclusions: There is a correlation among various kinds of spermatic vessels. Patients with grade 2 varicocele, especially who have multiple ISAs, are likely to have more ISVs and lymphatic vessels. For these patients, surgeons should pay more attention to protect spermatic arteries and lymphatics carefully while ligating varicose veins completely to prevent recurrence and complications.

Effect of whey protein on blood lipid profiles: a meta-analysis of randomized controlled trials

Previous studies have suggested that whey supplementation may have beneficial effects on lipid profiles, although results were inconsistent. A literature search was performed in March 2015 for randomized controlled trials observing the effects of whey protein and its derivatives on circulating levels of triacylglycerol (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C). A meta-analysis was subsequently conducted. The meta-analysis results of 13 trials showed that whey supplementation significantly reduced the circulating TG level by 0.11 mmol/l (95% CI: -0.21, 0 mmol/l), whereas the whey protein had no effects on circulating TC (-0.11 mmol/l, 95% CI: -0.27, 0.05 mmol/l), LDL-C (-0.08 mmol/l, 95% CI: -0.23, 0.07 mmol/l) and HDL-C (0.01 mmol/l, 95% CI: -0.04, 0.05 mmol/l). Subgroup analysis showed that significant TG reduction disappeared in participants with low body mass index, low supplemental whey dose or under exercise training/energy restriction during the trial. No evidence of heterogeneity across studies and publication bias was observed. In conclusion, our findings demonstrated that the effects of whey protein supplementation were modest, with an overall lowering effect on TG but no effect on TC, LDL-C and HDL-C.

Treadmill Running and Rutin Reverse High Fat Diet Induced Cognitive Impairment in Diet Induced Obese Mice

OBJECTIVES

To determine the effects of treadmill exercise training and rutin intervention independently and in combination on key molecules involved in Alzheimer's disease (AD) pathology and cognitive function in diet induced obese (DIO) mice.

METHODS

C57BL/6J mice were randomized into 5 groups: chow group, high fat diet group (HFD), HFD plus rutin intervention group (HR), HFD combined with treadmill running group (HE), HFD combined with treadmill running and rutin group (HRE). At the end of the intervention, Morris water maze test was conducted to assess hippocampal dependent, long term spatial learning and memory retention. Hippocampus and cortex were dissected and the protein expression of key molecules including insulin-degrading enzyme (IDE), Beta-secretase (BACE1), signal transducer and activator of transcription 3 (STAT3), cAMP-response element binding protein (CREB), post-synaptic density protein 95 (PSD-95) and synaptophysin were measured via western blotting.

RESULTS

Exercise and rutin enhances HFD induced cognitive deficits in DIO mice. In the hippocampus, although HFD has no effect on IDE, BACE1, phosphorylation (p)-STAT3 and p-CREB, HR and HE group have elevated protein expression of IDE; meanwhile, p-CREB was elevated in the HE and HRE group. In the cortex, HFD led to induction in BACE1 and reduction in p-STAT3 and PSD95. Rutin or exercise reversed BACE1, p-STAT3 and PSD95 to normal levels.

CONCLUSIONS

Treadmill running and rutin could improve HFD induced cognitive impairment, and p-STAT3, p-CREB, BACE1, IDE, and PSD95 are potential mediators involved in the protective effects of rutin or exercise against HFD induced cognitive dysfunction.

Varicocele anatomy during subinguinal microsurgical varicocelectomy in Chinese men

Knowledge of subinguinal microsurgical varicocelectomy is of fundamental importance to ensure that varicocele is resolved and testicular function is preserved. Our study aimed to describe the number of veins, arteries and lymphatics in the subinguinal spermatic cord and to clarify their differences between two sides, between patients with different complaints and between varicoceles with different clinical grades. A total of 102 consecutive patients underwent 162 primary subinguinal microsurgical varicocelectomies, during which the number of vessels with different diameters was recorded. A mean number of 12.9 internal spermatic veins, 0.9 external spermatic veins, 1.8 internal spermatic arteries and 2.9 lymphatics were identified per cord. 88.2% of the internal spermatic arteries were surrounded by a dense complex of adherent veins. The external spermatic vein or veins were found in 49.4% of the cases. The mean number of medium (1-3 mm in diameter) internal spermatic veins on the left was larger than that on the right (P < 0.001). The mean number of medium internal spermatic veins in grade III varicocele was larger than that in grade I or grade II (P < 0.015). There was no significant anatomical difference between the men presenting for infertility, chronic testicular pain and both the two complaints.

Evidence of b-jet quenching in PbPb collisions at √(s(NN))=2.76 TeV

The production of jets associated to bottom quarks is measured for the first time in PbPb collisions at a center-of-mass energy of 2.76 TeV per nucleon pair. Jet spectra are reported in the transverse momentum (p(T)) range of 80-250  GeV/c, and within pseudorapidity |η|<2. The nuclear modification factor (R(AA)) calculated from these spectra shows a strong suppression in the b-jet yield in PbPb collisions relative to the yield observed in pp collisions at the same energy. The suppression persists to the largest values of p(T) studied, and is centrality dependent. The R(AA) is about 0.4 in the most central events, similar to previous observations for inclusive jets. This implies that jet quenching does not have a strong dependence on parton mass and flavor in the jet p(T) range studied.

Observation of the associated production of a single top quark and a W boson in pp collisions at sqrt[s] = 8 TeV

The first observation of the associated production of a single top quark and a W boson is presented. The analysis is based on a data set corresponding to an integrated luminosity of 12.2 fb(-1) of proton-proton collisions at sqrt[s] = 8 TeV recorded by the CMS experiment at the LHC. Events with two leptons and a jet originating from a b quark are selected. A multivariate analysis based on kinematic and topological properties is used to separate the signal from the dominant tt background. An excess consistent with the signal hypothesis is observed, with a significance which corresponds to 6.1 standard deviations above a background-only hypothesis. The measured production cross section is 23.4 ± 5.4 pb, in agreement with the standard model prediction.

Probing color coherence effects in pp collisions at [Formula: see text]

A study of color coherence effects in pp collisions at a center-of-mass energy of 7[Formula: see text] is presented. The data used in the analysis were collected in 2010 with the CMS detector at the LHC and correspond to an integrated luminosity of 36 pb[Formula: see text]. Events are selected that contain at least three jets and where the two jets with the largest transverse momentum exhibit a back-to-back topology. The measured angular correlation between the second- and third-leading jet is shown to be sensitive to color coherence effects, and is compared to the predictions of Monte Carlo models with various implementations of color coherence. None of the models describe the data satisfactorily.

Study of the production of charged pions, kaons, and protons in pPb collisions at [Formula: see text]5.02[Formula: see text]

Spectra of identified charged hadrons are measured in pPb collisions with the CMS detector at the LHC at [Formula: see text]. Charged pions, kaons, and protons in the transverse-momentum range [Formula: see text]-1.7[Formula: see text] and laboratory rapidity [Formula: see text] are identified via their energy loss in the silicon tracker. The average [Formula: see text] increases with particle mass and the charged multiplicity of the event. The increase of the average [Formula: see text] with charged multiplicity is greater for heavier hadrons. Comparisons to Monte Carlo event generators reveal that Epos Lhc, which incorporates additional hydrodynamic evolution of the created system, is able to reproduce most of the data features, unlike Hijing and Ampt. The [Formula: see text] spectra and integrated yields are also compared to those measured in pp and PbPb collisions at various energies. The average transverse momentum and particle ratio measurements indicate that particle production at LHC energies is strongly correlated with event particle multiplicity.

Measurement of inclusive W and Z boson production cross sections in pp collisions at sqrt[s] = 8 TeV

A measurement of total and fiducial inclusive W and Z boson production cross sections in pp collisions at sqrt[s] = 8 TeV is presented. Electron and muon final states are analyzed in a data sample collected with the CMS detector corresponding to an integrated luminosity of 18.2 ± 0.5 pb(-1). The measured total inclusive cross sections times branching fractions are σ(pp → WX)×B(W → ℓν) = 12.21 ± 0.03(stat) ± 0.24(syst) ± 0.32(lum) nb and σ(pp → ZX) × B(Z → ℓ+ℓ-) = 1.15 ± 0.01(stat) ± 0.02(syst) ± 0.03(lum) nb for the dilepton mass in the range of 60-120 GeV. The measured values agree with next-to-next-to-leading-order QCD cross section calculations. Ratios of cross sections are reported with a precision of 2%. This is the first measurement of inclusive W and Z boson production in proton-proton collisions at sqrt[s] = 8 TeV.

Measurements of tt spin correlations and top-quark polarization using dilepton final states in pp collisions at sqrt[s]=7 TeV

Spin correlations and polarization in the top quark-antiquark system are measured using dilepton final states produced in pp collisions at the LHC at sqrt[s]=7  TeV. The data correspond to an integrated luminosity of 5.0  fb(-1) collected with the CMS detector. The measurements are performed using events with two oppositely charged leptons (electrons or muons), a significant imbalance in transverse momentum, and two or more jets, where at least one of the jets is identified as originating from a b quark. The spin correlations and polarization are measured through asymmetries in angular distributions of the two selected leptons, unfolded to the parton level. All measurements are found to be in agreement with predictions of the standard model.

Search for top-quark partners with charge 5/3 in the same-sign dilepton final state

A search for the production of heavy partners of the top quark with charge 5/3 is performed in events with a pair of same-sign leptons. The data sample corresponds to an integrated luminosity of 19.5 fb(-1) and was collected at sqrt[s] = 8 TeV by the CMS experiment. No significant excess is observed in the data above the expected background, and the existence of top-quark partners with masses below 800 GeV is excluded at a 95% confidence level, assuming they decay exclusively to tW. This is the first limit on these particles from the LHC, and it is significantly more restrictive than previous limits.

Search for flavor-changing neutral currents in top-quark decays t → Zq in pp collisions at sqrt[s] = 8 TeV

A search for flavor-changing neutral currents in top-quark decays t → Zq is performed in events produced from the decay chain tt → Zq+Wb, where both vector bosons decay leptonically, producing a final state with three leptons (electrons or muons). A data set collected with the CMS detector at the LHC is used, corresponding to an integrated luminosity of 19.7 fb(-1) of proton-proton collisions at a center-of-mass energy of 8 TeV. No excess is seen in the observed number of events relative to the standard model prediction; thus, no evidence for flavor-changing neutral currents in top-quark decays is found. A combination with a previous search at 7 TeV excludes a t → Zq branching fraction greater than 0.05% at the 95% confidence level.

Measurement of the top-quark mass in all-jets [Formula: see text] events in pp collisions at [Formula: see text] TeV

The mass of the top quark is measured using a sample of [Formula: see text] candidate events with at least six jets in the final state. The sample is selected from data collected with the CMS detector in pp collisions at [Formula: see text] TeV in 2011 and corresponds to an integrated luminosity of 3.54 [Formula: see text]. The mass is reconstructed for each event employing a kinematic fit of the jets to a [Formula: see text] hypothesis. The top-quark mass is measured to be [Formula: see text] GeV. A combination with previously published measurements in other decay modes by CMS yields a mass of [Formula: see text] GeV.

Jet and underlying event properties as a function of charged-particle multiplicity in proton-proton collisions at [Formula: see text]

Characteristics of multi-particle production in proton-proton collisions at [Formula: see text] are studied as a function of the charged-particle multiplicity, Nch. The produced particles are separated into two classes: those belonging to jets and those belonging to the underlying event. Charged particles are measured with pseudorapidity |η|<2.4 and transverse momentum pT>0.25 GeV/c. Jets are reconstructed from charged-particles only and required to have pT>5 GeV/c. The distributions of jet pT, average pT of charged particles belonging to the underlying event or to jets, jet rates, and jet shapes are presented as functions of Nch and compared to the predictions of the pythia and herwig event generators. Predictions without multi-parton interactions fail completely to describe the Nch-dependence observed in the data. For increasing Nch, pythia systematically predicts higher jet rates and harder pT spectra than seen in the data, whereas herwig shows the opposite trends. At the highest multiplicity, the data-model agreement is worse for most observables, indicating the need for further tuning and/or new model ingredients.

Search for top squarks in R-parity-violating supersymmetry using three or more leptons and b-tagged jets

A search for anomalous production of events with three or more isolated leptons and bottom-quark jets produced in pp collisions at √s=8 TeV is presented. The analysis is based on a data sample corresponding to an integrated luminosity of 19.5 fb(-1) collected by the CMS experiment at the LHC in 2012. No excess above the standard model expectations is observed. The results are interpreted in the context of supersymmetric models with signatures that have low missing transverse energy arising from light top-squark pair production with R-parity-violating decays of the lightest supersymmetric particle. In two models with different R-parity-violating couplings, top squarks are excluded below masses of 1020 GeV and 820 GeV when the lightest supersymmetric particle has a mass of 200 GeV.

Searches for new physics using the tt¯ invariant mass distribution in pp collisions at √s=8 TeV

Searches for anomalous top quark-antiquark production are presented, based on pp collisions at √s=8 TeV. The data, corresponding to an integrated luminosity of 19.7 fb(-1), were collected with the CMS detector at the LHC. The observed tt¯ invariant mass spectrum is found to be compatible with the standard model prediction. Limits on the production cross section times branching fraction probe, for the first time, a region of parameter space for certain models of new physics not yet constrained by precision measurements.

mTORC1/2 targeted by n-3 polyunsaturated fatty acids in the prevention of mammary tumorigenesis and tumor progression

Although epidemiological and preclinical studies have shown the preventative effects of n-3 polyunsaturated fatty acids (PUFAs) on breast cancer, inconsistencies still remain in the data and the underlying mechanisms remain unclear. In this study, we identified mammalian target of rapamycin (mTOR) signaling, which plays an essential role in cell proliferation and breast tumorigenesis, as a target of n-3 PUFAs. In breast cancer cell lines, n-3 PUFAs rapidly and efficiently suppress both mTOR complex 1 (mTORC1) and mTORC2 and their downstream signaling, and subsequently inhibit cell proliferation and angiogenesis while promoting apoptosis. Further study indicates that stabilization of the mTOR-raptor complex by n-3 PUFAs may contribute to their inhibitory effect on mTORC1. Importantly, four complementary and well-controlled animal models were utilized to identify the role and molecular target of n-3 PUFAs in the prevention of breast carcinogenesis and progression, namely: (1) chemically induced mammary tumor rats with a high dietary intake of n-3 PUFAs; (2) nude mice implanted with mammary tumor cell lines stably expressing fat-1, a desaturase that catalyzes the conversion of n-6 to n-3 PUFAs and produces n-3 PUFAs endogenously; (3) fat-1 transgenic severe combined immune deficiency mice implanted with breast tumor cells; and (4) the fat-1 transgenic mouse mammary tumor virus-polyoma virus middle T oncogene double-hybrid mice, a model of aggressive breast cancer. In summary, dietary and endogenous n-3 PUFAs abrogate the activity of mTORC1/2 pathways in vitro and in vivo and prevent breast carcinogenesis, tumor growth and metastasis. Taken together, our findings convincingly clarify the causal relationship between n-3 PUFAs and breast cancer prevention and establish mTORC1/2 as a target of n-3 PUFAs.