C-reactive protein to albumin ratio combined with the Systemic Inflammatory Response Index predicts the prognosis of patients undergoing radical hepatectomy

PURPOSE

Many prognostic scores based on systemic inflammation have been developed. Most of these prognostic scores have been shown to influence the prognosis of hepatocellular carcinoma (HCC) patients. This research aims to develop a novel prognostic system based on inflammatory markers for patients with HCC.

PATIENTS AND METHODS

This research encompassed 920 HCC patients who underwent potentially radical surgical resection. We employed receiver-operating characteristic (ROC) curve analysis to determine the optimal cutoff value for the preoperative inflammatory prognostic score. Univariate and multivariate Cox regression analyses were conducted to pinpoint features that significantly influence outcomes for patients with HCC. We employed a calibration curve and decision curve analysis (DCA) to appraise the application of the nomogram.

RESULTS

The multivariate Cox regression identified that systemic immunoinflammatory response index (SIRI), C-reactive protein-albumin ratio (CAR), tumor size, hepatitis B virus (HBV)-DNA, prothrombin time, microvascular invasion, macroscopic vascular invasion, and Edmondson-Steiner grade were all independent predictors of overall survival (OS). The predictive accuracy of the nomogram for estimating 1-, 3-, and 5-year OS was measured by the area under the receiver operating characteristic curve (AUC). In the training cohort, the AUC scores for the 1-, 3-, and 5-year OS were 0.815, 0.805, and 0.776. For the validation cohort, the respective AUC scores were 0.814, 0.737, and 0.730. Additionally, our nomogram shows a high capacity for distinguishing between different risk groups and is practical for clinical use.

CONCLUSION

The nomogram demonstrates strong predictive performance for the 1-, 3-, and 5-year OS of HCC patients undergoing radical surgery. The combination of related markers (SIRI, CAR, etc.) makes it more reliable and beneficial in predicting prognosis in HCC patients.

Enhancement and Compatibilization of Waste-Sourced Biocomposites Through Elastomer Blending and Matrix Grafting Modification

A novel elastomer-modified multicomponent, multiphase waste-sourced biocomposites, was prepared for converting waste biomass and plastic into value-added products. The effects of blending elastomer-olefin block copolymer (OBC) and maleic anhydride (MAH), and divinylbenzene (DVB) co-grafting of recycled polypropylene (rPP) matrix on the adhesion interface, structure, and properties of high wood flour-filled (60 wt.%) composites were thoroughly investigated. The results indicated that DVB introduced branched structures into the polymer matrix molecular chain and increased the MAH grafting rate. Co-grafting rPP/OBC blends enhanced the interfacial adhesion among rPP, OBC, and wood flour. Additionally, MAH-grafted OBC was prone to encapsulating rigid wood flour, thereby forming an embedded structure. Notably, the tensile modulus and impact strength of the final three-component composites increased by 60% and 125%, respectively, compared with the unmodified composites. Additionally, dynamic mechanical analysis revealed that DVB-induced branching promoted the formation of microvoids in the OBC shell layer surrounding the wood, which in turn induced significant plastic deformation in the polymer matrix. This work offers a facile and efficient method for preparing high-toughness, high-stiffness, and low-cost waste PP-based composites for automotive interiors, and indoor and outdoor decoration.

Two Sugarcane Expansin Protein-Coding Genes Contribute to Stomatal Aperture Associated with Structural Resistance to Sugarcane Smut

Sporisorium scitamineum is a biotrophic fungus responsible for inducing sugarcane smut disease that results in significant reductions in sugarcane yield. Resistance mechanisms against sugarcane smut can be categorized into structural, biochemical, and physiological resistance. However, structural resistance has been relatively understudied. This study found that sugarcane variety ZZ9 displayed structural resistance compared to variety GT42 when subjected to different inoculation methods for assessing resistance to smut disease. Furthermore, the stomatal aperture and density of smut-susceptible varieties (ROC22 and GT42) were significantly higher than those of smut-resistant varieties (ZZ1, ZZ6, and ZZ9). Notably, S. scitamineum was found to be capable of entering sugarcane through the stomata on buds. According to the RNA sequencing of the buds of GT42 and ZZ9, seven Expansin protein-encoding genes were identified, of which six were significantly upregulated in GT42. The two genes c111037.graph_c0 and c113583.graph_c0, belonging to the α-Expansin and β-Expansin families, respectively, were functionally characterized, revealing their role in increasing the stomatal aperture. Therefore, these two sugarcane Expansin protein-coding genes contribute to the stomatal aperture, implying their potential roles in structural resistance to sugarcane smut. Our findings deepen the understanding of the role of the stomata in structural resistance to sugarcane smut and highlight their potential in sugarcane breeding for disease resistance.

One-Step Synthesis of Nitrogen-Doped TiO2 Heterojunctions and Their Visible Light Catalytic Applications

In this study, nitrogen-doped TiO2 heterojunction materials were successfully synthesized via a facile one-step solvothermal approach. A range of advanced characterization techniques were employed to thoroughly analyze the structural and compositional properties of the synthesized photocatalysts, and their application potential for tetracycline (TC) degradation under visible light was studied. The results indicated that N-doped TiO2 exhibited a well-defined hierarchical micro/nanostructure and formed an efficient anatase/rutile homogeneous heterojunction. The photocatalytic performance of N-TiO2 for TC degradation under visible light was significantly enhanced, achieving a degradation efficiency of up to 87% after 60 min of irradiation. This improvement could be attributed to the synergistic effects of optimal nitrogen doping, heterojunction formation, and the hierarchical micro/nanostructure, which collectively reduced the bandgap energy and suppressed the recombination rate of photogenerated carriers. Furthermore, density functional theory (DFT) calculations were conducted to systematically explore the impacts of substitutional and interstitial nitrogen doping on the energy band structure of TiO2.

Bovine Neutrophil β-Defensin-5 Provides Protection against Multidrug-Resistant Klebsiella pneumoniae via Regulating Pulmonary Inflammatory Response and Metabolic Response

Klebsiella pneumoniae (K. pneumoniae), a kind of zoonotic bacteria, is among the most common antibiotic-resistant pathogens, and it causes nosocomial infections that pose a threat to public health. In this study, the roles of synthetic bovine neutrophil β-defensin-5 (B5) in regulating inflammatory response and metabolic response against multidrug-resistant K. pneumoniae infection in a mouse model were investigated. Mice were administrated intranasally with 20 μg of B5 twice and challenged with K. pneumoniae three days after B5 pretreatment. Results showed that B5 failed to directly kill K. pneumoniae in vitro, but it provided effective protection against multidrug-resistant K. pneumoniae via decreasing the bacterial load in the lungs and spleen, and by alleviating K. pneumoniae-induced histopathological damage in the lungs. Furthermore, B5 significantly enhanced the mRNA expression of TNF-α, IL-1β, Cxcl1, Cxcl5, Ccl17, and Ccl22 and obviously enhanced the rapid recruitment of macrophages and dendritic cells in the lungs in the early infection phase, but significantly down-regulated the levels of TNF-α, IL-1β, and IL-17 in the lungs in the later infection phase. Moreover, RNA-seq results showed that K. pneumoniae infection activated signaling pathways related to natural killer cell-mediated cytotoxicity, IL-17 signaling pathway, inflammatory response, apoptosis, and necroptosis in the lungs, while B5 inhibited these signaling pathways. Additionally, K. pneumoniae challenge led to the suppression of glycerophospholipid metabolism, the phosphotransferase system, the activation of microbial metabolism in diverse environments, and metabolic pathways in the lungs. However, B5 significantly reversed these metabolic responses. Collectively, B5 can effectively regulate the inflammatory response caused by K. pneumoniae and offer protection against K. pneumoniae. B5 may be applied as an adjuvant to the existing antimicrobial therapy to control multidrug-resistant K. pneumoniae infection. Our study highlights the potential of B5 in enhancing pulmonary bacterial clearance and alleviating K. pneumoniae-caused inflammatory damage.

Multi-Sensor Fusion for Wheel-Inertial-Visual Systems Using a Fuzzification-Assisted Iterated Error State Kalman Filter

This paper investigates the odometry drift problem in differential-drive indoor mobile robots and proposes a multi-sensor fusion approach utilizing a Fuzzy Inference System (FIS) within a Wheel-Inertial-Visual Odometry (WIVO) framework to optimize the 6-DoF localization of the robot in unstructured scenes. The structure and principles of the multi-sensor fusion system are developed, incorporating an Iterated Error State Kalman Filter (IESKF) for enhanced accuracy. An FIS is integrated with the IESKF to address the limitations of traditional fixed covariance matrices in process and observation noise, which fail to adapt effectively to complex kinematic characteristics and visual observation challenges such as varying lighting conditions and unstructured scenes in dynamic environments. The fusion filter gains in FIS-IESKF are adaptively adjusted for noise predictions, optimizing the rule parameters of the fuzzy inference process. Experimental results demonstrate that the proposed method effectively enhances the localization accuracy and system robustness of differential-drive indoor mobile robots in dynamically changing movements and environments.

Research on Visual-Inertial Measurement Unit Fusion Simultaneous Localization and Mapping Algorithm for Complex Terrain in Open-Pit Mines

As mining technology advances, intelligent robots in open-pit mining require precise localization and digital maps. Nonetheless, significant pitch variations, uneven highways, and rocky surfaces with minimal texture present substantial challenges to the precision of feature extraction and positioning in traditional visual SLAM systems, owing to the intricate terrain features of open-pit mines. This study proposes an improved SLAM technique that integrates visual and Inertial Measurement Unit (IMU) data to address these challenges. The method incorporates a point-line feature fusion matching strategy to enhance the quality and stability of line feature extraction. It integrates an enhanced Line Segment Detection (LSD) algorithm with short segment culling and approximate line merging techniques. The combination of IMU pre-integration and visual feature restrictions is executed inside a tightly coupled visual-inertial framework utilizing a sliding window approach for back-end optimization, enhancing system robustness and precision. Experimental results demonstrate that the suggested method improves RMSE accuracy by 36.62% and 26.88% on the MH and VR sequences of the EuRoC dataset, respectively, compared to ORB-SLAM3. The improved SLAM system significantly reduces trajectory drift in the simulated open-pit mining tests, improving localization accuracy by 40.62% and 61.32%. The results indicate that the proposed method demonstrates significance.

Refractory nontuberculous mycobacterial infection and potential hidden immunodeficiency related to RAG mutation and production of anti-interferon-α autoantibodies: a case report

BACKGROUND

Nontuberculous mycobacterial infectious diseases are associated with host immunological status. Neutralizing anti-interferon (IFN)-γ autoantibodies have been considered as a significant cause of nontuberculous mycobacterial infections. However, another autoantibody specifically targeting interferon-α, occurring in patients with nontuberculous mycobacterial infection, has been rarely reported.

CASE PRESENTATION

We report the case of a 23-year-old female who developed refractory nontuberculous mycobacterial infection and subsequently manifested skin lesions and motor disorder of muscles. The laboratory examination results showed elevated levels of globulin and immunoglobulin, as well as local deposits of amyloid material in pleural sections. Additionally, various tissue biopsies showed no evidence of malignancy. After 6 months of anti-nontuberculous mycobacterial therapy, the patient recovered normal temperature but developed progressive pulmonary lesions. The patient received steroids and methotrexate treatment and her skin lesions as well limitation of muscle movement improved. Further evaluation revealed a hidden immunodeficiency with positive anti-interferon-α autoantibodies and recombinase activating gene (RAG) mutation.

CONCLUSIONS

This case highlights alternation of infection and immune dysregulation, likely resulting from RAG mutation and production of anti-interferon-α autoantibodies.

Clinical characteristics of acquired anti-IFN-γ autoantibodies in patients infected with non-tuberculous mycobacteria: a prospective cohort study

BACKGROUND

Patients with positive anti-IFN-γ autoantibodies (AIGAs) are characterized by susceptibility to disseminated infection by multiple pathogens. The clinical characteristics of non-tuberculous mycobacterial (NTM) infection with AIGAs positivity remain unclear.

METHODS

A prospective cohort study was conducted at the First Affiliated Hospital of Guangxi Medical University from January 2021 to January 2024. A total of 93 patients diagnosed with NTM infection were divided into two groups: AIGAs-positive with NTM infection and AIGAs-negative with NTM infection. The clinical manifestations, laboratory data, imaging examination, and pathogens were analyzed to characterize the disease.

RESULTS

A total of 44 AIGAs-positive and 49 AIGAs-negative patients with NTM infection were enrolled. Disseminated infections were significantly more common among AIGAs-positive patients (P < 0.001), with frequent co-infections involving Talaromyces marneffei (TM) and viruses. Additionally, AIGAs-positive patients exhibited elevated inflammatory markers and immunoglobulins. In the AIGAs-positive group, lymph nodes, bones, skin, and blood were the most frequently affected sites. Chest CT scans exhibited a range of findings. Over a mean follow-up period of 36 months, 56.82% of patients with AIGAs positivity experienced exacerbations despite undergoing regular anti-NTM therapy.

CONCLUSIONS

AIGAs-positive patients with NTM infection exhibit elevated inflammatory markers, abnormal immune indicators, and coagulation function. Disseminated infections involving multiple organs are common, with frequent co-infection with TM and viruses. These patients may have unique symptoms, signs, and imaging findings compared to AIGAs-negative patients. Recurrence is common among these patients, highlighting the need for timely identification and intervention.

Bimetallic Ca/Zn Nanoagonist Remould the Immunosuppressive Hepatocellular Carcinoma Microenvironment Following Incomplete Microwave Ablation via Pyroptosis and the STING Signaling Pathway

During the treatment of solid tumors, local therapeutic approaches carry the risk of incomplete radical cure, which may lead to rapid tumor growth. Incomplete microwave ablation (iMWA) can induce tumors to exhibit highly invasive and uncontrollable growth, which is related to the immunosuppressive microenvironment. A multifunctional bimetallic Ca/Zn nanoagonist (PZH/Zn@CaNA) with a biomimetic liposome-modified surface to tumor tissues after iMWA is developed. In response to the acidic tumor microenvironment, the released traditional Chinese medicine preparation Pien Tze Huang (PZH) reduced protein expressions of the JAK2-STAT3 signaling pathway, thereby slowing down the proliferation and growth of hepatocellular carcinoma (HCC). Furthermore, the bimetallic ions Ca2⁺ and Zn2⁺ can cascade to enhance the killing effect of oxidative stress, generating substantial amounts of reactive oxygen species. This process induces pyroptosis and releases significant quantities of damage associated molecular patterns, thereby triggering immune activation mechanisms related to the STING pathway that reshape the immunosuppressive HCC microenvironment resulting from iMWA. This strategy markedly differs from previous chemoimmunotherapies, which not only effectively addressed the problem of conventional drugs showing heterogeneous distribution in tumor regions, but also verified the critical role played by PZH/Zn@CaNA in inhibiting iMWA-induced rapid tumor growth, regulating oxidative stress and remodeling the immunosuppressive tumor microenvironment.

Serum IgE in the clinical features and disease outcomes of anti-interferon-γ autoantibodies syndrome

BACKGROUND

Anti-interferon-γ autoantibodies (AIGAs) syndrome is a recently recognized adult-onset immunodeficiency syndrome. Serum Immunoglobulin E (IgE) is increased in AIGAs syndrome, but the role of serum IgE levels in the clinical features and disease outcomes of AIGAs syndrome is not clear.

METHODS

We retrospectively enrolled 163 patients diagnosed AIGAs syndrome with serum IgE examined at baseline from 2021 to 2024 and compared the clinical features between Group A (serum IgE level ≤ 212 IU/mL) and Group B (serum IgE level > 212 IU/mL). Multivariable logistic regression method was used to explore the risk factors associated with disease outcomes.

RESULTS

163 patients were included in this study, of whom 97 patients were in Group A (serum IgE level ≤ 212 IU/mL) and 66 patients in Group B (serum IgE level > 212 IU/mL). Group B showed higher number of infectious episodes, elevated levels of erythrocyte sedimentation rate (ESR), CD3 + T cells, immunoglobulin G (IgG), IgA, and globulins (GLB), shorter progression-free survival (PFS), and increased exacerbation numbers. Group B exhibited a higher incidence of fatigue, dyspnea, loss of appetite, rash, moist rales, hepatomegaly, and splenomegaly. Skin, bone marrow and spleen involvements were more common in Group B. IgE demonstrated correlations with IgG, GLB, Albumin (ALB), Eosinophils (EOS), IgG4, and ESR. During the follow-up, Group B exhibiting higher number of exacerbations compared to Group A (P < 0.0001). Multivariable Cox regression analysis revealed that High AIGAs titers (hazard ratio [HR], 2.418, 95% confidence interval [CI]1.037-5.642, P = 0.041), WBC > 22.52 × 109cells/L (HR2.199, 95%CI1.194-4.050, P = 0.012) were independent risk factors of disease exacerbation. Glucocorticoid treatment was commonly used in patients with AIGAs syndrome who had elevated IgE levels and skin involvement, demonstrating efficacy in improving condition.

CONCLUSIONS

Elevated serum IgE levels are associated with more severe clinical features in AIGAs syndrome, including increased infectious episodes, elevated inflammatory markers/immune markers, and multi-organ involvement, particularly skin. IgE serves as a marker of skin involvement and may indicate a potential response to glucocorticoid treatment.

Transcriptomic Analysis of Skin Tissue Reveals Molecular Mechanisms of Thermal Adaptation in Cold-Exposed Lambs

Cold stress impacts lamb mortality, welfare, and productivity. Wool and skin insulate lambs, but the mechanisms underlying their response to colder environments remain unclear. Shorn lambs (n = 20) of similar age (8 months), of the Hulunbuir (n = 10; average 34.5 ± 0.70 kg) and Hu (n = 10; average 34.9 ± 0.79 kg) breeds, were raised at the Ecological and Agricultural Experimental Station, Gaolan, Gansu Province, People's Republic of China (36°13″ N, 103°47″ E), at an altitude of 1780 m above sea level. These lambs were divided into four equal groups: Hulunbuir at -20 °C (HB-20), Hulunbuir at 15 °C (HB+15), Hu at -20 °C (HU-20), and Hu at 15 °C (HU+15). The groups were maintained at these temperatures in temperature-controlled facilities for 38 days. Skin tissues were analyzed with transcriptome sequencing, and selected wool and physiological traits were assessed. The HB-20 lambs had greater wool length growth (1.8 ± 0.13 vs. 1.0 ± 0.46 cm, p < 0.001) and epidermis thickness (20.0 ± 1.20 vs. 14.6 ± 0.87 μm, p = 0.006) but lower hair follicle density (33.6 ± 2.11 vs. 42.7 ± 3.06 per mm2, p = 0.041), rectal temperature (38.1 ± 0.10 vs. 38.8 ± 0.04 °C, p < 0.001), and respiratory rate (15.5 ± 1.08 vs. 24.0 ± 1.89 breaths/min, p = 0.004), compared to the HB+15 lambs. Similar differences in these traits were observed with the Hu lambs at the two temperatures. Transcriptome analyses revealed the activation of pathways related to immune and endocrine systems, signal transduction, and development and regeneration, irrespective of breed at -20 °C. The TNF signaling pathway and osteoclast differentiation may play roles in cold adaptation, as they are associated with differentially expressed genes (DEGs) identified in the Hulunbuir lambs, as well as shared DEGs between both breeds. This study revealed physiological and molecular differences in lambs exposed to lower temperatures and suggests potential targets for improving cold tolerance, welfare, and productivity.

2-dodecyl-6-methoxycyclohexa-2,5-diene-1,4-dione protects against MPP+-induced neurotoxicity by ameliorating oxidative stress, apoptosis and autophagy in SH-SY5Y cells

2-dodecyl-6-methoxycyclohexa-2,5-diene-1,4-dione (DMDD) is a cyclohexanedione compound extracted from the roots of Averrhoa carambola L. Several studies have documented its beneficial effects on diabetes, Alzheimer's disease, and cancer. However, its potential neuroprotective effects on Parkinson's disease (PD) have not yet been explored. The present study aimed to investigate the protective effects and underlying mechanisms of DMDD in a cellular model of PD. In this study, SH-SY5Y cells were incubated with or without DMDD following intoxication with the parkinsonian neurotoxin 1-methyl-4-phenylpyridine (MPP+). Cell viability and apoptosis were evaluated using 3-(4,5-Dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2 H-tetrazolium (MTS) assay and Hoechst 33,342 staining, respectively. The mitochondrial membrane potential (Δψm) was assessed through the JC-10 assay. The activities of superoxide dismutase (SOD) and the levels of reactive oxygen species (ROS) were measured using WST-8 and DCFH-DA assays. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed to explore significant biological processes and pathways influenced by DMDD. Molecular docking was employed to predict the domains of potential protein targets interacting with DMDD. Western blotting was subsequently conducted to determine the protein expression levels of TH, Nrf2, Bax, Bcl-2, Caspase-3, Beclin-1, PARP, LC3-II, LC3-I, p-PI3K, PI3K, p-mTOR and mTOR. Our study showed that DMDD treatment significantly increased cell viability and reduced apoptosis in MPP+-treated SH-SY5Y cells. In addition, DMDD treatment reversed the loss of TH expression and Δψm in MPP+-exposed SH-SY5Y cells. Moreover, DMDD treatment reduced MPP+-induced ROS production by promoting SOD activity. Additionally, compared with those in the MPP+ group, the protein expression levels of Beclin-1, Caspase-3, and PARP and the LC3II/I ratio were significantly decreased, whereas the protein expression levels of Nrf2 and the Bcl-2/Bax, p-PI3K/PI3K, and p-mTOR/mTOR ratios were significantly increased in the DMDD-treated group. In conclusion, DMDD protects against MPP+-induced cytotoxicity by mitigating oxidative stress, apoptosis, and autophagy. PI3K/mTOR signaling at least partly mediates the cytoprotective effect of DMDD.

A Multi-Level Speed Guidance Cooperative Approach Based on Bidirectional Periodic Green Wave Coordination Under Intelligent and Connected Environment

To maximize arterial green wave bandwidth utilization, this study aims to minimize average travel delays at coordinated intersections and maximize vehicle throughput. In view of the aforementioned points, the present paper sets out a collaborative optimization method for the control of related intersection groups. The method combines multi-level speed guidance with green wave coordinated control. In an intelligent and connected environment (ICE), the driving trajectory of the initial vehicle is determined in each optimization cycle following the receipt of active speed guidance. Subsequently, the driving trajectories of subsequent vehicles are calculated, with an assessment made as to whether they can leave the intersection before the end of the green light. The subsequent step involves the calculation of a characteristic index, comprising the average speed of the arterial coordination section and its corresponding phase offset. The phase offset is then optimized with the objective of maximizing the comprehensive bandwidth of green wave coordination within the control range. The maximum average speed and the bidirectional cycle comprehensive green wave bandwidth are employed as the control objectives. Finally, a model is constructed through the combination of multi-level vehicle speed guidance with bidirectional cycle green wave coordinated control. A bi-level combinatorial optimization method is constructed through a combinatorial deep Q learning method, named Deep Q Network-Genetic Algorithm (DQNGA), with the objective of obtaining the global optimal solution. Finally, the reliability of the method is validated using traffic flow data and map sensor data on several associated road sections in a city. The results demonstrate that the proposed method reduces the average delay and number of stops by 20.76% and 44.49%, respectively, outperforming conventional traffic control strategies. This suggests that the issue of inefficient utilization of green light time in arterial coordinated signal control has been effectively addressed. Consequently, the efficiency of intersections in the intelligent and connected environment has been enhanced.