Comparison of patient-controlled analgesia and sedation (PCAS) with remifentanil and propofol versus total intravenous anesthesia (TIVA) with midazolam, fentanyl, and propofol for colonoscopy.

BACKGROUND: Colonoscopy is a commonly performed gastroenterological procedure in patients associated with anxiety and pain. Various approaches have been used to provide sedation and analgesia during colonoscopy, including patient-controlled analgesia and sedation (PCAS). This study aims to evaluate the feasibility and efficiency of PCAS administered with propofol and remifentanil for colonoscopy. METHODS: This randomized controlled trial was performed in an authorized and approved endoscopy center. A total of 80 outpatients were recruited for the colonoscopy studies. Patients were randomly allocated into PCAS and total intravenous anesthesia (TIVA) groups. In the PCAS group, the dose of 0.1 ml/kg/min of the mixture was injected after an initial bolus of 3 ml mixture (1 ml containing 3 mg of propofol and 10 µg of remifentanil). Each 1 ml of bolus was delivered with a lockout time of 1 min. In the TIVA group, patients were administered fentanyl 1 µg/kg, midazolam 0.02 mg/kg, and propofol (dosage titrated). Cardiorespiratory parameters and auditory evoked response index were continuously monitored during the procedure. The recovery from anesthesia was assessed using the Aldrete scale and the Observer's Assessment of Alertness/Sedation Scale. The Visual Analogue Scale was used to assess the satisfaction of patients and endoscopists. RESULTS: No statistical differences were observed in the Visual Analogue Scale scores of the patients (9.58 vs 9.50) and the endoscopist (9.43 vs 9.30). A significant decline in the mean arterial blood pressure, heart rate, and auditory evoked response index parameters was recorded in the TIVA group (P < 0.05). The recovery time was significantly shorter in the PCAS group than in the TIVA group (P = 0.00). CONCLUSION: The combination of remifentanil and propofol could provide sufficient analgesia, better hemodynamic stability, lighter sedation, and faster recovery in the PCAS group of patients compared with the TIVA group.

The causal associations of circulating lipids with Barrett's Esophagus and Esophageal Cancer: a bi-directional, two sample mendelian randomization analysis.

OBJECTIVE: The causal associations of circulating lipids with Barrett's Esophagus (BE) and Esophageal Cancer (EC) has been a topic of debate. This study sought to elucidate the causality between circulating lipids and the risk of BE and EC. METHODS: We conducted two-sample Mendelian randomization (MR) analyses using single nucleotide polymorphisms (SNPs) of circulating lipids (n = 94,595 - 431,167 individuals), BE (218,792 individuals), and EC (190,190 individuals) obtained from the publicly available IEU OpenGWAS database. The robustness and reliability of the results were ensured by employing inverse-variance weighted (IVW), weighted median, MR-Egger, and MR-PRESSO methods. The presence of horizontal pleiotropy, heterogeneities, and stability of instrumental variables were assessed through MR-Egger intercept test, Cochran's Q test, and leave-one-out sensitivity analysis. Additionally, bidirectional MR and multivariable MR (MVMR) were performed to explore reverse causality and adjust for known confounders, respectively. RESULTS: None of the testing methods revealed statistically significant horizontal pleiotropy, directional pleiotropy, or heterogeneity. Univariate MR analyses using IVW indicated a robust causal relationship between increased triglycerides and BE (odds ratio [OR] = 1.79, p-value = 0.009), while no significant association with EC was observed. Inverse MR analysis indicated no evidence of reverse causality in the aforementioned outcomes. In MVMR analyses, elevated triglycerides (TRG) were significantly and positively associated with BE risk (OR = 1.79, p-value = 0.041). CONCLUSION: This MR study suggested that genetically increased triglycerides were closely related to an elevated risk of BE, potentially serving as a biomarker for the diagnosis of BE in the future.

Spatiotemporal dual-periodic soliton pulsation in a multimode fiber laser.

Spatiotemporal mode-locked (STML) fiber lasers have become a new platform for investigating nonlinear phenomena. In this work, spatiotemporal dual-periodic soliton pulsation (SDSP) is firstly observed in an STML fiber laser. It is found that in the SDSP, the long-period pulsations (LPPs) of different transverse modes are synchronous, while the short-period pulsations (SPPs) exhibit asynchronous modulations. The numerical simulation confirms the experimental results and further reveals that the proportion of transverse mode components can manipulate the periods of the LPP and SPP but does not affect the synchronous and asynchronous pulsations of different transverse modes. The obtained results bring the study of spatiotemporal dissipative soliton pulsation into the multi-period modulation stage, which helps to understand the complex spatiotemporal dynamics in STML fiber lasers and discover new dynamics in high-dimensional nonlinear systems.

Rare case report: a case of histological type transformation of lung cancer caused by neoadjuvant immunotherapy.

Lung cancer remains the leading cause of cancer-related mortality, with 1.8 million deaths per year. Small cell lung cancer and non-small cell lung cancer (NSCLC) are the main cancer types. Approximately 85% of cases are NSCLC, including adenocarcinoma, squamous cell carcinoma, and large cell carcinoma. In this reported treatment case, the tumor histological type changed after targeted therapy, which has not been previously well documented. The patient was a 67-year-old woman diagnosed with squamous cell carcinoma via bronchoscopy. She received five neoadjuvant immune monotherapies. The lesion shrank but then progressed, with a diagnosis of small cell carcinoma via bronchoscopy. This finding suggests that tumor acquisition of resistance as manifested by cancer-type changes needs consideration and study in the application of this particular type of immunotherapy.

Evaluation of neoadjuvant immunotherapy in resectable gastric/gastroesophageal junction tumors: a meta-analysis and systematic review.

Background: Neoadjuvant therapy for resectable gastric cancer/gastroesophageal junction tumors is progressing slowly. Although immunotherapy for advanced gastric cancer/gastroesophageal junction tumors has made great progress, the efficacy and safety of neoadjuvant immunotherapy for locally resectable gastric cancer/gastroesophageal junction tumors have not been clearly demonstrated. Here, we conducted a systematic review and meta-analysis to assess the efficacy and safety of neoadjuvant immunotherapy and advance the current research. Methods: Original articles describing the safety and efficacy of neoadjuvant immunotherapy for resectable gastric cancer/gastroesophageal junction tumors published up until October 15, 2023 were retrieved from PubMed, Embase, the Cochrane Library, and other major databases. The odds ratios (OR) and 95% confidence intervals (CIs) were calculated for heterogeneity and subgroup analysis. Results: A total of 1074 patients from 33 studies were included. The effectiveness of neoadjuvant immunotherapy was mainly evaluated using pathological complete remission (PCR), major pathological remission (MPR), and tumor regression grade (TRG). Among the included patients, 1015 underwent surgical treatment and 847 achieved R0 resection. Of the patients treated with neoadjuvant immunotherapy, 24% (95% CI: 19%-28%) achieved PCR and 49% (95% CI: 38%-61%) achieved MPR. Safety was assessed by a surgical resection rate of 0.89 (95% CI: 85%-93%), incidence of ≥ 3 treatment-related adverse events (TRAEs) of 28% (95% CI: 17%-40%), and incidence of ≥ 3 immune-related adverse events (irAEs) of 19% (95% CI: 11%-27%). Conclusion: Neoadjuvant immunotherapy, especially neoadjuvant dual-immunotherapy combinations, is effective and safe for resectable gastric/gastroesophageal junction tumors in the short term. Nevertheless, further multicenter randomized trials are required to demonstrate which combination model is more beneficial. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=358752, identifier CRD42022358752.

Periodically tunable multimode soliton pulsation in a spatiotemporal mode-locked fiber laser.

Multimode fiber lasers have become a new platform for investigating nonlinear phenomena since the report on spatiotemporal mode-locking. In this work, the multimode soliton pulsation with a tunable period is achieved in a spatiotemporal mode-locked fiber laser. It demonstrates that the pulsation period drops while increasing the pump power. Moreover, it is found that different transverse modes have the same pulsation period, asynchronous pulsation evolution and different dynamical characteristics through the spatial sampling technique and the dispersive Fourier transform technique. To further verify the experimental results, we numerically investigate the influences of the gain and the loss on the pulsation properties. It is found that within a certain parameter range, the pulsation period drops and rises linearly with the increase of the gain and the loss, respectively. The obtained results contribute to understanding the formation and regulating of soliton pulsations in fiber lasers.

MoS2-Based Memristor: Robust Resistive Switching Behavior and Reliable Biological Synapse Emulation.

Memristors are recognized as crucial devices for future nonvolatile memory and artificial intelligence. Due to their typical neuron-synapse-like metal-insulator-metal(MIM) sandwich structure, they are widely used to simulate biological synapses and have great potential in advancing biological synapse simulation. However, the high switch voltage and inferior stability of the memristor restrict the broader application to the emulation of the biological synapse. In this study, we report a vertically structured memristor based on few-layer MoS2. The device shows a lower switching voltage below 0.6 V, with a high ON/OFF current ratio of 104, good stability of more than 180 cycles, and a long retention time exceeding 3 × 103 s. In addition, the device has successfully simulated various biological synaptic functions, including potential/depression propagation, paired-pulse facilitation (PPF), and long-term potentiation/long-term depression (LTP/LTD) modulation. These results have significant implications for the design of a two-dimensional transition-metal dichalcogenides composite material memristor that aim to mimic biological synapses, representing promising avenues for the development of advanced neuromorphic computing systems.

Advances in Brain Tumor Therapy Based on the Magnetic Nanoparticles.

Brain tumors, including primary gliomas and brain metastases, are one of the deadliest tumors because effective macromolecular antitumor drugs cannot easily penetrate the blood-brain barrier (BBB) and blood-brain tumor barrier (BTB). Magnetic nanoparticles (MNPs) are considered the most suitable nanocarriers for the delivery of brain tumor drugs because of their unique properties compared to other nanoparticles. Numerous preclinical and clinical studies have demonstrated the potential of these nanoparticles in magnetic targeting, nuclear magnetic resonance, magnetic thermal therapy, and ultrasonic hyperthermia. To further develop and optimize MNPs for the diagnosis and treatment of brain tumors, we attempt to outline recent advances in the use of MNPs to deliver drugs, with a particular focus on their efficacy in the delivery of anti-brain tumor drugs based on magnetic targeting and low-intensity focused ultrasound, magnetic resonance imaging for surgical real-time guidance, and magnetothermal and ultrasonic hyperthermia therapy. Furthermore, we summarize recent findings on the clinical application of MNPs and the research limitations that need to be addressed in clinical translation.

Study on the detection method of biological characteristics of hepatoma cells based on terahertz time-domain spectroscopy.

Liver cancer usually has a high degree of malignancy and its early symptoms are hidden, therefore, it is of significant research value to develop early-stage detection methods of liver cancer for pathological screening. In this paper, a biometric detection method for living human hepatocytes based on terahertz time-domain spectroscopy was proposed. The difference in terahertz response between normal and cancer cells was analyzed, including five characteristic parameters in the response, namely refractive index, absorption coefficient, dielectric constant, dielectric loss and dielectric loss tangent. Based on class separability and variable correlation, absorption coefficient and dielectric loss were selected to better characterize cellular properties. Maximum information coefficient and principal component analysis were employed for feature extraction, and a cell classification model of support vector machine was constructed. The results showed that the algorithm based on parameter feature fusion can achieve an accuracy of 91.6% for human hepatoma cell lines and one normal cell line. This work provides a promising solution for the qualitative evaluation of living cells in liquid environment.

Attribution of lake eutrophication risk to anthropogenic forcing adjacent to the agriculture areas: a case study of Chagan Lake.

Lake eutrophication, exacerbated by high-intensity anthropogenic forcing, threatens water ecological security and the sustainable development of fisheries. Accurately evaluating lake eutrophication is the basis for effective management of the water environment. This study aimed to study eutrophication and its anthropogenic forcing in Chagan Lake, which is surrounded by agricultural areas with irrigation discharge as the primary water source. The spatiotemporal evolution characteristics of lake eutrophication and the anthropogenic forcing factors were analyzed based on the long-series multi-source data and modified eutrophication index. The results showed that (1) the average trophic state of Chagan Lake was eutrophic according to the modified eutrophication index (TLI = 58.31) and the nutrient level was higher in summer, reaching hypertrophy (TLI 61.49); (2) the maximum pollution footprint affecting the lake reached 34.7 km2, with a maximum buffer zone radius of 1 km; (3) the gross domestic product of primary industry, total sown area, and rice field area were the main anthropogenic factors leading to the lake eutrophication, with contribution rates of 64.43%, 13.09%, and 10.23%, respectively. Multidimensional management strategies for maximum pollution footprint, buffer zone radius, and contribution of anthropogenic factors were used to improve the water quality of the lake. The findings provided scientific support for the management of water environment of Chagan Lake and guided the formulation of "one lake, one policy."

Optimizing environmental flow based on a new optimization model in balancing objectives among river ecology, water supply and power generation in a high-latitude river.

Environmental flow plays an important role in maintaining the health of river ecosystems and aquatic habitats. Although ecological regulation of environmental flow has attracted the attention of scientists, managing the world's reservoir-regulated rivers to better meet the needs of human being and ecosystems is a complex social challenge. To address the above issues, we constructed a model for optimizing reservoir operation based on a balance in achieving multi objectives among environmental flow, water supply and power generation (EWP). The model was solved using an intelligent multi-objective optimization algorithm (ARNSGA-III). The developed model was demonstrated in a large reservoir, Laolongkou Reservoir in the Tumen River. The results showed that the reservoir altered environmental flows mainly in terms of flow magnitude, peak, times, duration and frequency, which result in a sharp decrease in spawning fish, and degradation and replacement of vegetation along the channels. In addition, the mutual feedback relationship between the objectives of environmental flows, water supply and power generation is not static, but varies over time and space. The constructed model based on Indicators of Hydrologic Alteration (IHAs) can effectively guarantee the environmental flow at daily scale. In detail, the river ecological benefit increased by 64% in wet year, 68% in normal year, 68% in dry year after optimizing regulation of reservoir, respectively. This study will provide a scientific reference for the optimizing of the management in other rivers affected by dams.

Identifying nitrate sources and transformations in an agricultural watershed in Northeast China: Insights from multiple isotopes.

Accurate identification of riverine nitrate sources is required for preventing and controlling nitrogen contamination in agricultural watersheds. The water chemistry and multiple stable isotopes (δ15N-NO3, δ18O-NO3, δ2H-H2O, and δ18O-H2O) of the river water and groundwater in an agricultural watershed in China's northeast black soil region were analyzed to better understand the sources and transformations of riverine nitrogen. Results showed that nitrate is an important pollutant that affects water quality in this watershed. Affected by factors such as seasonal rainfall changes and spatial differences in land use, the nitrate concentrations in the river water showed obvious temporal and spatial variations. The riverine nitrate concentration was higher in the wet season than in the dry season, and higher downstream than upstream. The water chemistry and dual nitrate isotopes revealed that riverine nitrate came primarily from manure and sewage (M&S). Results from the SIAR model showed that it accounted for more than 40% of riverine nitrate in the dry season. The proportional contribution of M&S decreased during the wet season due to the increased contribution of chemical fertilizers and soil nitrogen induced by large amounts of rainfall. The δ2H-H2O and δ18O-H2O signatures implied that interactions occurred between the river water and groundwater. Considering the large accumulation of nitrates in the groundwater, restoring groundwater nitrate levels is essential for controlling riverine nitrate pollution. As a systematic study on the sources, migration, and transformations of nitrate/nitrogen in agricultural watersheds in black soil regions, this research can provide a scientific support for nitrate pollution management in the Xinlicheng Reservoir watershed and provide a reference for other watersheds in black soil regions in the world with similar conditions.

Molecular Epidemiology of Bovine Enteroviruses and Genome Characterization of Two Novel Bovine Enterovirus Strains in Guangxi, China.

Bovine enterovirus (BEV) is a highly infectious pathogen that may cause respiratory and gastrointestinal disease outbreaks in cattle. This study aimed to investigate the prevalence and genetic characteristics of BEVs in Guangxi Province, China. A total of 1,168 fecal samples from 97 different bovine farms were collected between October 2021 and July 2022 in Guangxi Province, China. BEV was confirmed using a reverse transcription-PCR (RT-PCR) method targeting the 5' untranslated region (UTR), and isolates were genotyped by sequencing their genomes. The nearly complete genome sequences of eight BEV strains showing cytopathic effects in MDBK cells were determined and analyzed. In total, 125 (10.7%) of 1,168 fecal samples were positive for BEV. BEV infection was significantly associated with farming patterns and clinical symptoms (P < 0.05; odds ratio [OR] > 1). Molecular characterization indicated that five BEV strains from this study belonged to EV-E2 and one strain to EV-E4. Two BEV strains (GXNN2204 and GXGL2215) could not be assigned to a known type. Strain GXGL2215 showed the closest genetic relationship with GX1901 (GenBank accession number MN607030; China) in its VP1 (67.5%) and P1 (74.7%) and with NGR2017 (MH719217; Nigeria) in its polyprotein (72.0%). It was also close to the EV-E4 strain GXYL2213 from this study when the complete genome (81.7%) was compared. Strain GXNN2204 showed the closest genetic relationship with Ho12 (LC150008; Japan) in the VP1 (66.5%), P1 (71.6%), and polyprotein (73.2%). Genome sequence analysis suggested that strains GXNN2204 and GXGL2215 originated from the genomic recombination of EV-E4 and EV-F3 and EV-E2 and EV-E4, respectively. This study reports the cocirculation of multiple BEV types and the identification of two novel BEV strains in Guangxi, China, and it will provide further insights into the epidemiology and evolution of BEV in China. IMPORTANCE Bovine enterovirus (BEV) is a pathogen that causes intestinal, respiratory, and reproductive disease infections in cattle. This study reports on the widespread prevalence and biological characteristics of the different BEV types which currently exist in Guangxi Province, China. It also provides a reference for the study of the prevalence of BEV in China.

Mechanistic insights into CDCP1 clustering on non-small-cell lung cancer membranes revealed by super-resolution fluorescent imaging.

CDCP1 is a transmembrane protein that is involved in a variety of important biological processes and upregulated in a variety of human solid malignancies; however, its spatial distribution and variation at the molecular level remain unclear. To solve this problem, we first analyzed its expression level and prognostic implications in lung cancer. Then, we used super-resolution microscopy to reveal the spatial organization of CDCP1 at different levels, and found that cancer cells generated more and larger CDCP1 clusters than normal cells. Furthermore, we found that CDCP1 can be integrated into larger and denser clusters as functional domains upon activation. Our findings elucidated the significant differences of CDCP1 clustering characteristics between cancer and normal cells, and revealed the relationship between its distribution and function, which will contribute to a comprehensive understanding of its oncogenic mechanism, and will be of great help for the development of CDCP1-targeted drugs for lung cancer.

Erratum: Mechanistic insights into CDCP1 clustering on non-small-cell lung cancer membranes revealed by super-resolution fluorescent imaging.

[This corrects the article DOI: 10.1016/j.isci.2023.106103.].

A comprehensive study of the source, occurrence, and spatio-seasonal dynamics of 12 target antibiotics and their potential risks in a cold semi-arid catchment.

Antibiotics are widely consumed and are ubiquitous in aquatic ecosystems, such as in agricultural and fishery lake catchments, for prophylactic treatment. However, there are very few comprehensive studies reporting all seasonal occurrences, spatiotemporal dynamics, and risk assessments of antibiotics in agricultural lake catchments, especially in cold regions during the winter season. This study measured seasonality in the concentrations of 12 antibiotics belonging to seven different classes in the surface waters (tributary rivers and lakes) of the Chagan lake catchment in northeast China. All antibiotics were detected in most of the water samples across most seasons, with concentrations varying for different compounds, locations, and seasons. These levels were discussed in terms of the main sources at different sampling sites, including agriculture, fish farming, municipal wastewater, and others. In general, the highest concentrations of most compounds were observed during the freeze-thaw periods. The number of antibiotic resistance genes (ARGs) correlated with compound lipophilicity and half-life. Based on the ecological risks of antibiotics and the relative abundance of ARGs, a hierarchical control priority list (HCPL) of antibiotics was determined, considering four levels (critical, high, medium, and low). To further strengthen the control and effectively manage antibiotics, we highly recommend the reduction and selective use of veterinary antibiotics in winter and spring during the freeze-thaw periods in the Chagan lake catchment.

Combination of GNRs-PEI/cGAMP-laden macrophages-based photothermal induced in situ tumor vaccines and immune checkpoint blockade for synergistic anti-tumor immunotherapy.

Immunotherapy is an effective strategy to control and eliminate primary and metastatic tumor by restarting and restoring the specific anti-tumor immune response. However, tumor immunotherapy often showed limited efficacy due to the poor T cell responses in vivo and the tumor suppressive microenvironments. Herein, we constructed polyethyleimine modified gold nanorods (GNRs-PEI) by conjugating PEI to GNRs via SAu bonds. GNRs-PEI/cGAMP nanoparticles were formed via electrostatic interaction and then loaded by macrophages. The GNRs-PEI/cGAMP-laden macrophages (GPc-RAWs) were intravenously injected into the tumor bearing mice and the in situ tumor vaccines were obtained after NIR irradiation. Besides, anti-PD-L1 antibody, an immune checkpoint inhibitor, was introduced to reverse immunosuppressive microenvironment and assisted to achieve the synergistic anti-tumor immunotherapy. GNRs-PEI/cGAMP-laden macrophages with NIR irradiation could effectively inhibit the primary tumors, while little effect for the contralateral tumors. When combined with anti-PD-L1 antibody, the combined strategy not only inhibited the growth of primary tumor, but also significantly delayed the proliferation of the contralateral tumors. More importantly, this strategy reversed immunosuppressive microenvironment without obvious side effects. Therefore, this study provided a great immunotherapy platform for the efficient treatment of primary and metastatic tumors.

CDCP1: A promising diagnostic biomarker and therapeutic target for human cancer.

CUB domain-containing protein 1 (CDCP1), as an emerging transmembrane protein, is overexpressed in a variety of malignant tumors including respiratory tumors, digestive system cancers, hematological malignancies and urogenital cancers. Several cancer-related proteins have been reported to interact with CDCP1. It acts as a crucial hub in multiple classical signaling pathways of tumorigenesis and progression. Its overexpression and activation are also associated with prognosis and drug resistance. Due to its important roles in malignant tumors, CDCP1 is expected to be a promising therapeutic target for treatment and a new biomarker for diagnosis. In this article, we review the roles of CDCP1 in diagnosis and management of malignant tumors, and also its regulation in several essential tumor-related pathways.