Fluorescence imaging-guided surgery: current status and future directions.

Surgery is one of the most important paradigms for tumor therapy, while fluorescence imaging (FI) offers real-time intraoperative guidance, greatly boosting treatment prognosis. The imaging fidelity heavily relies on not only imaging facilities but also probes for imaging-guided surgery (IGS). So far, a great number of IGS probes with emission in visible (400-700 nm) and near-infrared (NIR 700-1700 nm) windows have been developed for pinpointing disease margins intraoperatively. Herein, the state-of-the-art fluorescent probes for IGS are timely updated, with a special focus on the fluorescent probes under clinical examination. For a better demonstration of the superiority of NIR FI over visible FI, both imaging modalities are critically compared regarding signal-to-background ratio, penetration depth, resolution, tissue autofluorescence, photostability, and biocompatibility. Various types of fluorescence IGS have been summarized to demonstrate its importance in the medical field. Furthermore, the most recent progress of fluorescent probes in NIR-I and NIR-II windows is summarized. Finally, an outlook on multimodal imaging, FI beyond NIR-II, efficient tumor targeting, automated IGS, the use of AI and machine learning for designing fluorescent probes, and the fluorescence-guided da Vinci surgical system is given. We hope this review will stimulate interest among researchers in different areas and expedite the translation of fluorescent probes from bench to bedside.

Usefulness of Shear Wave Elastography in Determining the Tumor Extent of Basal Cell Carcinomas.

OBJECTIVES: The purpose of this study was to investigate the value of shear wave elastography (SWE) in determining tumor extent of basal cell carcinomas (BCC), and thereby determine the optimal surgical margins (OSM). METHODS: 10 patients (40 surgical margins) with BCC were collected, the visual observation boundaries (VOB) were marked, and the SWE parameters of soft tissues were measured 1 mm intervals in "3, 6, 9, 12" clock directions, starting from VOB. Then tumors were resected with a 5 mm surgical margin outward expansion of VOB. All specimens were examined pathologically 1 mm intervals from VOB in four clock directions. With the positive margins furthest from the tumor as the real tumor boundaries (RTB) and the negative margins closest to the tumor as the optimal surgical margins (OSM). The SWE parameters were compared between these two groups. RESULTS: The elasticity ratio (Eratio ) of average young's modulus between region of interest and adjacent normal soft tissue had statistically significant differences between groups (P = .000), while other parameters show no difference. The Eratio of RTB and OSM were 1.22 ± 0.14 and 0.99 ± 0.07. The area under the ROC curve was .947. Taking 1.075 as the threshold of Eratio for the diagnosis of tumor extent, the sensitivity, specificity and accuracy were 87.5%, 90.0% and 90.0%. The surgical margins designed according to OSM were better than those designed according to VOB + 5 mm (P = .000). CONCLUSIONS: The Eratio of SWE is helpful in determining tumor extent of BCC. This is beneficial for surgical margin designing.

Digital Technology, Knowledge Level, and Food Safety Governance: Implications for National Healthcare System.

Exploring the intrinsic relationship between digital technology and the efficiency of food safety supervision contributes to a better understanding of the role of digital technology in food safety supervision and how to maximize its influence. This study employed sample data from 31 regions in China between 2015 and 2017 for an empirical analysis of the correlation between the two and to examine the moderating effects of the knowledge levels of food producers and consumers. The results show that the development of digital technology contributes to enhancing the efficiency of food safety supervision. In this process, the higher the knowledge level of consumers, the greater the positive promotional effect of digital technology. On the contrary, when the knowledge level of producers is higher, it is not conducive to enhancing the effect of digital technology on the efficiency of food safety supervision. The author holds the view that this is related to the fact that employees in the food production and manufacturing industry have insufficient moral and legal knowledge. This not only limits the effect of digital technology on enhancing the efficiency of food safety supervision, but also opens the door to illegal production for some unprincipled producers. The policy implications are that digital technology should be used to improve food safety supervision, the moral and legal knowledge of food producers should be improved, and consumers should be encouraged to use digital technology more in the pursuit of food safety. Implications for national healthcare system would be also discussed in our paper.

Mapping the Finer-Scale Carcinogenic Risk of Polycyclic Aromatic Hydrocarbons (PAHs) in Urban Soil-A Case Study of Shenzhen City, China.

The high-precision mapping of urban health risk is a difficult problem due to the high heterogeneity of the urban environment. In this paper, the spatial distribution characteristics of the Polycyclic Aromatic Hydrocarbon (PAH) content in the urban soil of Shenzhen City were analyzed through a field investigation. We propose an approach for improving the accuracy and spatial resolution of PAH carcinogenic risk assessment by integrating the pollutant distribution and Location Based Service (LBS) data. The results showed that the concentration of PAHs in the high-density urban area was 271.67 ng g-1, which was 27.2% higher than that in the green area. Although the average carcinogenic risk of PAHs in the surface soil of Shenzhen city was less than 10-6, the maximum carcinogenic risk at some sample sites exceeded 10-6, which indicates a potential health risk. The LBS data were effective for high-precision mapping of the population distribution. According to the combination relationship between the risk threshold of pollutants and the population density, four types of risk zones were proposed. Among them, 6.9% of the areas had a high-risk and high population density and 15.8% of the areas were high-risk with a low population density. These two kinds of zones were the critical areas for controlling risk. The fine-scale risk mapping approach for determining the carcinogenic risk of soil PAHs integrating pollutant distribution and location based service data was demonstrated to be a useful tool for explicit spatial risk management. This tool could provide spatial insights and decision support for urban health-risk management and pollution prevention.

Improving spatial prediction of health risk assessment for Hg, As, Cu, and Pb in soil based on land-use regression.

Heavy-metal pollution is a significant health and environmental concern in areas of rapid industrialization in China. The accuracy of spatial mapping of pollutant is the main constraint on spatial prediction of health risks. Our study addressed the possibility of improving spatial prediction accuracy of risk assessment. We developed land-use regression (LUR) models for Hg, As, Cu, and Pb based on surface soil sampling, land-use data, and soil properties. The regression results suggested that LUR was more accurate than ordinary kriging method. Spatial prediction accuracy of Hg, As, Cu, and Pb were improved by 15%, 59%, 36%, and 20%, respectively. Then, spatial distribution of health risk was assessed by using distributions of heavy metal and exposure parameters. Chronic risk of children was controlled by distribution of Pb and carcinogenic controlled by As. The result indicated that Pb and As were the main sources of health risk for children in Kunshan. Chronic and carcinogenic risk maps could clearly show where we should pay attention to and control the risk. This study provided a simple approach to draw spatially explicit maps of health risk which were useful for pollution control and public health risk management.

Improving risk management by using the spatial interaction relationship of heavy metals and PAHs in urban soil.

Identifying combined pollution risk areas is difficult because of the complex pollutant sources and heterogeneous soil properties in urban systems. This study used bivariate local Moran's I to analyze the spatial interaction between heavy metals and PAHs, revealed the causes of spatial interaction patterns through PMF, and proposed a risk zoning approach for combined pollution in urban areas. The results showed that both heavy metals and PAHs had high spatial heterogeneity in urban soil. Bivariate LISA maps revealed the spatial interactions between heavy metals and PAHs. The historical area was the hotspot of combined pollution. The overlay of pollutant sources and sinks was responsible for the spatial interaction patterns of combined organic and inorganic pollution. Coal consumption was the main emission source for heavy metal and PAHs pollution, accounting for 31% and 21%, respectively. We used bivariate LISA as the auxiliary variable to reduce the uncertainty of identification combined pollution risk zones. More than 11% of the total area clustered significantly where concentration of both heavy metals and PAHs ware in excess of the risk threshold. This study indicates that we can provide better decision-making support for soil risk management based on the knowledge derived from spatial interaction analysis.

Urban sprawl decreases the value of ecosystem services and intensifies the supply scarcity of ecosystem services in China.

Land use and land cover changes, particularly land take by urbanization, can degrade ecosystems and their capacity to provide humans with numerous benefits, namely, ecosystem services (ES). Many studies on the relationship between urbanization and the supply and demand of ES have been conducted. However, studies on the process and trend of the conflict between ES supply and demand, as well as the spatial differences, are lacking. Developing countries around the world are experiencing rapid urbanization. The aim of this study was to summarize the relationship between urbanization and the supply and demand of ES in China. China has experienced rapid urbanization since the reform and opening up, and the urban population reached 56.10% in 2015. Urban sprawl was twice that of population expansion, and led to a loss in value of ES. We calculated the loss in value of the five ES (food production, water conservation, climate regulation, habitat support and cultural service) due to the increase in construction area by means of spatial analysis. The total loss was US $110.95 billion in China from 1985 to 2015. This result indicated that the increases in construction land area had a negative impact on ES. At the same time, there was a conflict between the scarcity index of ES and their loss in value. The leading cause of this conflict was that economic development was highly dependent on the area of urban construction land. The results suggested that we should adopt "intensive" and "compact" strategic development models, quantify the value of ES, focus on the conflict between the loss in value and ES supply, and try our best to reduce the decline in ES in the future.

UNBS5162 induces growth inhibition and apoptosis via inhibiting PI3K/AKT/mTOR pathway in triple negative breast cancer MDA-MB-231 cells.

UNBS5162, a naphthalimide derivative, has a strong anticancer effect and low clinical hematological toxicity. UNBS5162 has been shown to have an anticancer effect in numerous cancer types, except triple negative breast cancer (TNBC). To explore this issue, TNBC MDA-MB-231 cells were selected, and the effect of UNBS5162 on their growth, proliferation and motility regulation was investigated in vitro. The results showed that UNBS5162 significantly inhibited the proliferation, migration and invasion of TNBC cells. In addition, the level of pro-apoptosis protein Bcl-2-associated X protein and active caspase-3 increased, but apotptosis regulator BCL-2 decreased in MDA-MB-231 cells after UNBS5162 treatment, which demonstrated UNBS5162 treatment triggered cell apoptosis. Moreover, UNBS5162 reduced the phosphorylation levels of AKT serine/threonine kinase (AKT), mechanistic target of rapamycin kinase (mTOR), P70S6 kinase and eukaryotic translation initiation factor 4E-binding protein 1 in the phosphatidylinositol 3-kinase/AKT/mTOR (PAM) signaling pathway, which plays a critical role in cell proliferation, and apoptosis. Altogether, the results of the present study suggest that UNBS5162 effectively induces the growth inhibition and apoptosis of TNBC cells through regulation of the PAM pathway, which may be a candidate target for TNBC treatment.

Determining the contributions of urbanisation and climate change to NPP variations over the last decade in the Yangtze River Delta, China.

Terrestrial net primary production (NPP) is an important measure of global change, and identifying the relative contributions of urbanisation and climate change to NPP is important for understanding the impact of human and natural influences on terrestrial systems and the carbon cycle. The objective of this study was to reveal how urbanisation and climate drive changes in NPP. Satellite-based estimates of NPP collected over a 12-year period (1999-2010) were analysed to identify NPP variations in the Yangtze River Delta. Temporal and spatial analysis methods were used to identify the relationships among NPP, nighttime light urbanisation index values, and climatic factors from pixel to regional scales. The NPP of the entire Yangtze River Delta decreased slightly at a rate of -0.5 g C m(-2)a(-1) from 1999 to 2010, but this change was not significant. However, in the urban region, NPP decreased significantly (p<0.05) at a rate of -4.7 g C m(-2)a(-1) due to urbanisation processes. A spatially explicit method was proposed to partition the relative contributions of urbanisation and climate change to NPP variation. The results revealed that the urbanisation factor is the main driving force for NPP change in high-speed urbanisation areas, and the factor accounted for 47% of the variations. However, in the forest and farm regions, the NPP variation was mainly controlled by climate change and residual factors.