RotatedStomataNet: a deep rotated object detection network for directional stomata phenotype analysis.

KEY MESSAGE: Innovatively, we consider stomatal detection as rotated object detection and provide an end-to-end, batch, rotated, real-time stomatal density and aperture size intelligent detection and identification system, RotatedeStomataNet. Stomata acts as a pathway for air and water vapor in the course of respiration, transpiration, and other gas metabolism, so the stomata phenotype is important for plant growth and development. Intelligent detection of high-throughput stoma is a key issue. Nevertheless, currently available methods usually suffer from detection errors or cumbersome operations when facing densely and unevenly arranged stomata. The proposed RotatedStomataNet innovatively regards stomata detection as rotated object detection, enabling an end-to-end, real-time, and intelligent phenotype analysis of stomata and apertures. The system is constructed based on the Arabidopsis and maize stomatal data sets acquired destructively, and the maize stomatal data set acquired in a non-destructive way, enabling the one-stop automatic collection of phenotypic, such as the location, density, length, and width of stomata and apertures without step-by-step operations. The accuracy of this system to acquire stomata and apertures has been well demonstrated in monocotyledon and dicotyledon, such as Arabidopsis, soybean, wheat, and maize. The experimental results that the prediction results of the method are consistent with those of manual labeling. The test sets, the system code, and their usage are also given ( https://github.com/AITAhenu/RotatedStomataNet ).

[Effects of Biochar on Growth and Pollutant Accumulation of Lettuce in Soil Co-contaminated with Tetracycline and Copper].

Through lettuce potting experiments, the effects of different types of biochar (apple branch, corn straw, and modified sorghum straw biochar with phosphoric acid modification) on lettuce growth under tetracycline (TC) and copper (Cu) co-pollution were investigated. The results showed that compared with those under CK, the addition of biochar treatment significantly increased the plant height, root length, shoot fresh weight, and root fresh weight of lettuce (P < 0.05). The addition of different biochars significantly increased the nitrate nitrogen, chlorophyll, and soluble protein content in lettuce physiological indicators to varying degrees, while also significantly decreasing the levels of malondialdehyde, proline content, and catalase activity. The effects of biochar on lettuce physiological indicators were consistent during both the seedling and mature stages. Compared with those in CK, the addition of biochar resulted in varying degrees of reduction in the TC and Cu contents of both the aboveground and underground parts of lettuce. The aboveground TC and Cu levels decreased by 2.49%-92.32% and 12.79%-36.47%, respectively. The underground TC and Cu levels decreased by 12.53%-55.64% and 22.41%-42.29%, respectively. Correlation analysis showed that nitrate nitrogen, chlorophyll, and soluble protein content of lettuce were negatively correlated with TC content, whereas malondialdehyde, proline content, and catalase activity were positively correlated with TC content. The resistance genes of lettuce were positively correlated with TC content (P < 0.05). In general, modified biochar was found to be more effective in improving lettuce growth quality and reducing pollutant accumulation compared to unmodified biochar, with modified sorghum straw biochar showing the best remediation effect.

One-pot green solid-state synthesis of Cu2O/microcrystalline cellulose composite with high anti-pathogenic activity.

Cuprous oxide (Cu2O) is proven as an excellent anti-harmful microbial material. However, the liquid and vapor pha5se preparation methods reported so far hardly make pure Cu2O-containing composites and suffer environmental issues caused by chemical reducing agents with multiple processing steps. This work develops a facile one-pot solid-state sintering method to synthesize Cu2O/microcrystalline cellulose (MCC) composite via the thermal decomposition and oxidation-reduction reactions where copper formate was reduced by MCC. The Cu2O/MCC composite exhibits superior purity, dispersibility, stability, high yield, and high efficacy of antibacterial and antiviral properties, e.g., against E. coli, S. aureus, and Equine Arteritis Viral. This work utilizes elegantly the strong reducing capability of cellulose to develop an environmentally benign method to prepare high-purity Cu2O-polymer composites with low cytotoxicity and cost, which can be incorporated readily into other substrate materials to form various forms of anti-harmful microbial materials widely used in public health care products. In addition, the preparation of Cu2O-containing composites based on the reducing capability of cellulose is also expected to be applied to other cellulose-based materials for the loading of Cu2O particles.

A Senescence-Associated Secretory Phenotype of Bone Marrow Mesenchymal Stem Cells Inhibits the Viability of Breast Cancer Cells.

Breast cancer, the most prevalent malignancy in women, often progresses to bone metastases, especially in older individuals. Dormancy, a critical aspect of bone-metastasized breast cancer cells (BCCs), enables them to evade treatment and recur. This dormant state is regulated by bone marrow mesenchymal stem cells (BMMSCs) through the secretion of various factors, including those associated with senescence. However, the specific mechanisms by which BMMSCs induce dormancy in BCCs remain unclear. To address this gap, a bone-specific senescence-accelerated murine model, SAMP6, was utilized to minimize confounding systemic age-related factors. Confirming senescence-accelerated osteoporosis, distinct BMMSC phenotypes were observed in SAMP6 mice compared to SAMR1 counterparts. Notably, SAMP6-BMMSCs exhibited premature senescence primarily due to telomerase activity loss and activation of the p21 signaling pathway. Furthermore, the effects of conditioned medium (CM) derived from SAMP6-BMMSCs versus SAMR1-BMMSCs on BCC proliferation were examined. Intriguingly, only CM from SAMP6-BMMSCs inhibited BCC proliferation by upregulating p21 expression in both MCF-7 and MDA-MB-231 cells. These findings suggest that the senescence-associated secretory phenotype (SASP) of BMMSCs suppresses BCC viability by inducing p21, a pivotal cell cycle inhibitor and tumor suppressor. This highlights a heightened susceptibility of BCCs to dormancy in a senescent microenvironment, potentially contributing to the increased incidence of breast cancer bone metastasis and recurrence observed with aging.

Dapagliflozin ameliorates hepatic steatosis via suppressing LXRα-mediated synthesis of lipids and bile acids.

Nonalcoholic fatty liver disease (NAFLD) prevalence is rising globally with no pharmacotherapies approved. Hepatic steatosis is closely associated with progression and prognosis of NAFLD. Dapagliflozin, kind of sodium-glucose cotransporter 2 (SGLT2) inhibitor, was found to improve NAFLD in clinical trials, while the underlying mechanism remains poorly elucidated. Here, we reported that dapagliflozin effectively mitigated liver injury and relieved lipid metabolism disorders in vivo. Further investigation showed that dapagliflozin markedly suppressed Liver X Receptor α (LXRα)-mediated synthesis of de novo lipids and bile acids (BAs). In AML12 cells, our results proved dapagliflozin decreased lipid contents via inhibiting the expression of LXRα and downstream liposynthesis genes. Proteosome inhibitor MG132 eliminated the effect of dapagliflozin on LXRα-mediated signaling pathway, which suggested that dapagliflozin downregulated LXRα expression through increasing LXRα degradation. Knockdown of LXRα with siRNA abolished the reduction of lipogenesis from dapagliflozin treatment, indicating that LXRα might be the pivotal target for dapagliflozin to exhibit the aforementioned benefits. Furthermore, the data showed that dapagliflozin reversed gut dysbiosis induced by BAs disruption and altered gut microbiota profile to reduce intestinal lipids absorption. Together, our study deciphered a novel mechanism by which dapagliflozin relieved hepatic steatosis and highlighted the potential benefit of dapagliflozin in treating NAFLD.

Mn Cluster-Embedded N/F Co-Doped Carbon toward Mild Aqueous Supercapacitors.

Aqueous supercapacitors have occupied a significant position among various types of stationary energy storage equipment, while their widespread application is hindered by the relatively low energy density. Herein, N/F co-doped carbon materials activated by manganese clusters (NCM) are constructed by the straightforward experimental routine. Benefiting from the elevated conductivity structure at the microscopic level, the optimized NCM-0.5 electrodes exhibited a remarkable specific capacitance of 653 F g-1 at 0.4 A g-1 and exceptional cycling stability (97.39% capacity retention even after 40,000 cycles at the scanning rate of 100 mV s-1) in a neutral 5 M LiCl electrolyte. Moreover, we assembled an asymmetric device pairing with a VOx anode (NCM-0.5//VOx), which delivered a durable life span of 95% capacity retention over 30,000 cycles and an impressive energy density of 77.9 Wh kg-1. This study provides inspiration for transition metal element doping engineering in high-energy storage equipment.

Within-Session Reliability of fNIRS in Robot-Assisted Upper-Limb Training.

Functional near-infrared spectroscopy (fNIRS) seems opportune for neurofeedback in robot-assisted rehabilitation training due to its noninvasive, less physical restriction, and no electromagnetic disturbance. Previous research has proved the cross-session reliability of fNIRS responses to non-motor tasks (e.g., visual stimuli) and fine-motor tasks (e.g., finger tapping). However, it is still unknown whether fNIRS responses remain reliable 1) in gross-motor tasks, 2) within a training session, and 3) for different training parameters. Hence, this study aimed to investigate the within-session reliability of fNIRS responses to gross-motor tasks for different training parameters. Ten healthy participants were recruited to conduct right elbow extension-flexion in three robot-assisted modes. The Passive mode was fully motor-actuated, while Active1 and Active2 modes involved active engagement with different resistance levels. FNIRS data of three identical runs were used to assess the within-session reliability in terms of the map- ( R2 ) and cluster-wise ( Roverlap ) spatial reproducibility and the intraclass correlation (ICC) of temporal features. The results revealed good spatial reliability ( R2 up to 0.69, Roverlap up to 0.68) at the subject level. Besides, the within-session temporal reliabilities of Slope, Max/Min, and Mean were between good and excellent ( ICC < 0.86). We also found that the within-session reliability was positively correlated with the intensity of the training mode, except for the temporal reliability of HbO in Active2 mode. Overall, our results demonstrated good within-session reliability of fNIRS responses, suggesting fNIRS as reliable neurofeedback for constructing closed-loop robot-assisted rehabilitation systems.

Psychometric properties of the Chinese version of the health behavior motivation scale: a translation and validation study.

Objective: This study's objectives were to translate the Health Behavior Motivation Scale (HBMS) into Chinese and verify the scale's validity and reliability among Chinese healthy adults. Method: The HBMS scales were translated into Chinese based on Brislin's principles. The Chinese version of HBMS is created through translation, back translation, and cross-cultural adaptation. This investigation implemented the convenience sampling method to conduct a survey on 781 healthy respondents, utilizing the Chinese version of the HBMS and a general demographic questionnaire. We used AMOS (v28.0) and SPSS (v26.0) for statistical analysis. We employed test-retest reliability, split-half reliability, and internal consistency to assess the reliability of the translation questionnaire. Structure validity and content validity were used to assess validity. Results: The Chinese version of the Health Behavior Motivation Scale (HBMS) had a Cronbach's alpha coefficient of 0.885, and the range of Cronbach's alpha values for each dimension was 0.820-0.885. The scale's test-retest reliability was 0.824, and its split-half reliability was 0.906. Five public factors with a cumulative variance contribution of 56.527% were retrieved from the exploratory factor analysis. Moreover, the factor loading value for each item exceeded 0.4.In confirmatory factor analysis, the indicators were reported as follows: χ2/df = 1.567, GFI = 0.900, CFI = 0.952, IFI = 0.952, TLI = 0.946, AGFI = 0.881, PGFI = 0.757, PNFI = 0.789, RMSEA = 0.039, and the results of the model fit metrics were within the reference range. Conclusion: The Chinese version of the HBMS exhibits strong discrimination, validity, and reliability. The tool effectively identifies the motivation of healthy people to engage in healthy behaviors. It can be used by healthcare practitioners to assist in the development of follow-up interventions to reduce the prevalence of chronic disease in older people and the incidence of chronic disease in populations of young and middle-aged people.

Putting it Together, Together.

People are not as fast or as strong as many other creatures that evolved around us. What gives us an evolutionary advantage is working together to achieve common aims. Coordinating joint action begins at a tender age with such cooperative activities as alternating babbling and clapping games. Adult joint activities are far more complex and use multiple means of coordination. Joint action has attracted qualitative analyses by sociolinguists, cognitive scientists, and philosophers as well as empirical analyses and theories by cognitive scientists. Here, we analyze how joint action is spontaneously coordinated from start to finish in a novel complex real-life joint activity, assembling a piece of furniture, a task that captures the essentials of joint action, collaborators, things in the world, and communicative devices. Pairs of strangers assembled a TV cart from a stack of parts and a photo of the completed cart. Coordination prior to each assembly action was coded as explicit, using speech or gesture, or implicit, actions that both advanced the task and communicated the next step. Initial planning relied on explicit communication about structure, but not action nor division of labor, which were improvised. That served to establish a joint representation of the goal that informed actions and monitored progress. As assembly progressed, coordination was increasingly implicit, through actions alone. Joint action is a dynamic interplay of explicit and implicit signaling with respect to things in the world to coordinate ongoing progress, guided by a shared representation of the goal.

SLPA-Net: a real-time recognition network for intelligent stomata localization and phenotypic analysis.

Plant stomatal phenotype traits play an important role in improving crop water use efficiency, stress resistance and yield. However, at present, the acquisition of phenotype traits mainly relies on manual measurement, which is time-consuming and laborious. In order to obtain high-throughput stomatal phenotype traits, we proposed a real-time recognition network SLPA-Net for stomata localization and phenotypic analysis. After locating and identifying stomatal density data, ellipse fitting is used to automatically obtain phenotype data such as apertures. Aiming at the problems of small stomata and high similarity to background, we introduced ECANet to improve the accuracy of stoma and aperture location. In order to effectively alleviate the unbalance problem in bounding box regression, we replaced the Loss function with a more effective Focal EIoU Loss. The experimental results show that SLPA-Net has excellent performance in the migration generalization and robustness of stomata and apertures detection and identification, as well as the correlation between stomata phenotype data obtained and artificial data. For convenience, we developed SLPA-Net into a freely available software, the software can be obtained at https://github.com/AITAhenu/SLPA.

Study protocol for a prediction model for mild cognitive impairment in older adults with diabetes mellitus and construction of a nurse-led screening system: a prospective observational study.

INTRODUCTION: With an increasing number of older adults in China, the number of people with cognitive impairment is also increasing. To decrease the risk of dementia, it is necessary to timely detect mild cognitive impairment (MCI), which is the preliminary stage of dementia. The prevalence of MCI is relatively high among older adults with diabetes mellitus (DM); however, no effective screening strategy has been designed for this population. This study will construct a nurse-led screening system to detect MCI in community-dwelling older adults with DM in a timely manner. METHODS AND ANALYSIS: A total of 642 participants with DM will be recruited (n=449 for development, n=193 for validation). The participants will be divided into MCI and none-MCI groups. The candidate predictors will include demographic variables, lifestyle factors, history of diseases, physical examinations, laboratory tests and neuropsychological tests. Univariate analysis, least absolute shrinkage and selection operator regression screening, and multivariate logistic regression analysis will be conducted to identify the outcome indicators. Based on the multivariate logistic regression equation, we will develop a traditional model as a comparison criterion for the machine learning models. The Hosmer-Lemeshow goodness-of-fit test and calibration curve will be used to evaluate the calibration. Sensitivity, specificity, area under the curves and clinical decision curve analysis will be performed for all models. We will report the sensitivity, specificity, area under the curve and decision curve analysis of the validation dataset. A prediction model with better performance will be adopted to form the nurse-led screening system. ETHICS AND DISSEMINATION: This prospective study has received institutional approval of the Medical Ethics Committee of Qidong Hospital of TCM (QDSZYY-LL-20220621). Study results will be disseminated through conference presentations, Chinese Clinical Trial Registry and publication. TRIAL REGISTRATION NUMBER: ChiCTR2200062855.

Iron-Single-Atom Nanozyme with NIR Enhanced Catalytic Activities for Facilitating MRSA-Infected Wound Therapy.

Patients with methicillin-resistant Staphylococcus aureus (MRSA) infections may have higher death rates than those with non-drug-resistant infections. Nanozymes offer a promising approach to eliminating bacteria by producing reactive oxygen species. However, most of the conventional nanozyme technologies encounter significant challenges with respect to size, composition, and a naturally low number of active sites. The present study synthesizes a iron-single-atom structure (Fe-SAC) via nitrogen doped-carbon, a Fe-N5 catalyst (Fe-SAC) with a high metal loading (4.3 wt.%). This catalyst permits the development of nanozymes consisting of single-atom structures with active sites resembling enzymes, embedded within nanomaterials. Fe-SAC displays peroxidase-like activities upon exposure to H2O2. This structure facilitates the production of hydroxyl radicals, well-known for their strong bactericidal effects. Furthermore, the photothermal properties augment the bactericidal efficacy of Fe-SAC. The findings reveal that Fe-SAC disrupts the bacterial cell membranes and the biofilms, contributing to their antibacterial effects. The bactericidal properties of Fe-SAC are harnessed, which eradicates the MRSA infections in wounds and improves wound healing. Taken together, these findings suggest that single Fe atom nanozymes offer a novel perspective on the catalytic mechanism and design, holding immense potential as next-generation nanozymes.

Acoustic Higher-Order Topological Insulators Induced by Orbital-Interactions.

The discovery of higher-order topological insulator metamaterials, in analogy with their condensed-matter counterparts, has enabled various breakthroughs in photonics, mechanics, and acoustics. A common way of inducing higher-order topological wave phenomena is through pseudo-spins, which mimic the electron spins as a symmetry-breaking degree of freedom. Here we exploit degenerate orbitals in acoustic resonant cavities to demonstrate versatile, orbital-selective, higher-order topological corner states. Type-II corner states are theoretically investigated and experimentally demonstrated based on tailored orbital interactions, without the need for long-range hoppings that has so far served as a key ingredient for Type-II corner states in single-orbital systems. Due to the orthogonal nature of the degenerate p orbitals, we also introduce a universal strategy to realize orbital-dependent edge modes, featuring high-Q edge states identified in bulk bands. Our findings provide an understanding of the interplay between acoustic orbitals and topology, shedding light on orbital-related topological wave physics, as well as its applications for acoustic sensing and trapping. This article is protected by copyright. All rights reserved.

Reliability and validity of the cancer-related dysfunctional beliefs and attitudes about sleep scale in cancer patients.

BACKGROUND: Insomnia is a common health problem among cancer patients, which is not only a physical problem but also a psychological problem. Sleep plays an important role in the mental and somatic rehabilitation of cancer patients, and the sleep beliefs and attitudes of cancer patients are key factors in improving their sleep situation and quality of life. The aim of this study was to translate the Cancer-Related Dysfunctional Beliefs and Attitudes about Sleep (C-DBAS-14) scale into Chinese and to validate its reliability and validity in cancer patients. METHOD: The C-DBAS-14 scale was translated into Chinese using the backward and forward translation procedure. The reliability of the scale was measured by internal consistency, split-half reliability and retest reliability. The validity of the scale was assessed through the content validity indicators, exploratory factor analysis and validation factor analysis. RESULT: The Cronbach's ɑ coefficient of the Chinese version of the C-DBAS-14 was 0.932 while the McDonald's omega coefficient (ω t) was 0.934. The split-half reliability coefficient was 0.908, and the test-retest reliability was 0.857. The four-factor model was obtained using exploratory factor analysis, explaining 72.7% of the variance, with each item loading greater than 0.4 on the common factor. The results of the confirmatory factor analysis revealed that all indicators of model fit were within an acceptable range, indicating a well-fitting model. CONCLUSION: The Chinese version of the C-DBAS-14 has good reliability and validity among cancer patients. It can be used to measure the sleep beliefs and attitudes of Chinese cancer patients.

[FMECA and Failure Data Analysis of Domestic Wheeled Walking-Aid].

The gradual acceleration of the aging population in China has led to an increased demand for mobility aids, and the reliability of domestic wheeled walking-aid is one of their important attributes, but there is little research on the reliability of mobility aids. This paper conducts the failure mode, effects and criticality analysis on domestic wheeled walking-aid. By collecting, collating and analyzing the 26 failure modes, the key modules are the chassis and the lifting system. The key modules are obtained, and the failure data is analyzed to find out that the lifetime distribution model is log-normal and the 0.95 lower confidence limit for reliability life of product t 0.9 is 2489.4 hours. The study aims to provide ideas for the reliability analysis of other active medical devices and calls for the formation of a reliability study review point for the industry that meets the requirements of Chinese medical device regulations.

A novel simplified approach for endodontic retrograde surgery in short single-rooted teeth.

BACKGROUND: High technical thresholds, long operative times, and the need for expensive and specialized equipment impede the widespread adoption of endodontic microsurgery in many developing countries. This study aimed to compare the effects of a simplified, cost-effective, and time-efficient surgical approach involving orthograde obturation using biological ceramic material greater than 6 mm combined with apicoectomy for single-rooted teeth with short lengths with those of the conventional and current standard methods. MATERIALS AND METHODS: Forty-five premolars equally categorized into three groups: conventional surgery group, standard surgery group, and modified surgery group. A µCT scan was used to calculate the volume of voids. A micro-leakage test and scanning electron microscope (SEM) were performed to assess the sealing effect. Additionally, four cases of chronic periapical periodontitis in the anterior region were selected, and the patients received either the modified approach or the standard surgery for endodontic microsurgery. RESULTS: The volumes of voids in the apical 0-3 mm of the modified group and the standard group were comparable. The micro-leakage test and SEM examination demonstrated closely bonded fillings in the dentinal walls in both the modified surgery group and standard surgery group. The outcomes of the preliminary application of this modified procedure on patients were successful at the time of the follow-up cutoff. CONCLUSIONS: The modified surgery group exhibited similar root canal filling and apical sealing abilities with the standard procedure for single-rooted teeth with short lengths (< 20 mm). The preliminary application of this modified surgical procedure achieved favorable results.

Arrestin-3 binds parkin and enhances parkin-dependent mitophagy.

Arrestins were discovered for their role in homologous desensitization of G-protein-coupled receptors (GPCRs). Later non-visual arrestins were shown to regulate several signaling pathways. Some of these pathways require arrestin binding to GPCRs, the regulation of others is receptor independent. Here, we demonstrate that arrestin-3 binds the E3 ubiquitin ligase parkin via multiple sites, preferentially interacting with its RING0 domain. Identification of the parkin domains involved suggests that arrestin-3 likely relieves parkin autoinhibition and/or stabilizes the enzymatically active "open" conformation of parkin. Arrestin-3 binding enhances ubiquitination by parkin of the mitochondrial protein mitofusin-1 and facilitates parkin-mediated mitophagy in HeLa cells. Furthermore, arrestin-3 and its mutant with enhanced parkin binding rescue mitofusin-1 ubiquitination and mitophagy in the presence of the Parkinson's disease-associated R275W parkin mutant, which is defective in both functions. Thus, modulation of parkin activity via arrestin-3 might be a novel strategy of anti-parkinsonian therapy.

Treatment-related pneumonitis after thoracic radiotherapy/chemoradiotherapy combined with anti-PD-1 monoclonal antibodies in advanced esophageal squamous cell carcinoma.

PURPOSE: This study aims to evaluate the risk factors of treatment-related pneumonitis (TRP) following thoracic radiotherapy/chemoradiotherapy combined with anti-PD­1 monoclonal antibodies (mAbs) in patients with advanced esophageal squamous cell carcinoma (ESCC). METHODS: We retrospectively reviewed 97 patients with advanced ESCC who were treated with thoracic radiotherapy/chemoradiotherapy combined with anti-PD­1 mAbs. Among them, 56 patients received concurrent radiotherapy with anti-PD­1 mAbs and 41 patients received sequential radiotherapy with anti-PD­1 mAbs. The median prescribed planning target volume (PTV) dose was 59.4 Gy (range from 50.4 to 66 Gy, 1.8-2.2 Gy/fraction). Clinical characteristics, the percentage of lung volume receiving more than 5-50 Gy in increments of 5 Gy (V5-V50, respectively) and the mean lung dose (MLD) were analyzed as potential risk factors for TRP. RESULTS: 46.4% (45/97), 20.6% (20/97), 20.6% (20/97), 4.1% (4/97), and 1.0% (1/97) of the patients developed any grade of TRP, grade 1 TRP, grade 2 TRP, grade 3 TRP, and fatal (grade 5) TRP, respectively. Anti-PD­1 mAbs administered concurrently with radiotherapy, V5, V10, V15, V25, V30, V35, V40 and MLD were associated with the occurrence of grade 2 or higher TRP. Concurrent therapy (P = 0.010, OR = 3.990) and V5 (P = 0.001, OR = 1.126) were independent risk factors for grade 2 or higher TRP. According to the receiver operating characteristic (ROC) curve analysis, the optimal V5 threshold for predicting grade 2 or higher TRP was 55.7%. CONCLUSION: The combination of thoracic radiotherapy/chemoradiotherapy with anti-PD­1 mAbs displayed a tolerable pulmonary safety profile. Although the incidence of TRP was high, grade 1-2 TRP accounted for the majority. Anti-PD­1 mAbs administered concurrently with radiotherapy and the lung V5 were significantly associated with the occurrence of grade 2 or higher TRP. Therefore, it seems safer to control V5 below 55% in clinical, especially for the high-risk populations receiving concurrent therapy.

Effects of intermittent dieting with break periods on body composition and metabolic adaptation: a systematic review and meta-analysis.

CONTEXT: Intermittent dieting incorporated with break periods (INT-B) has recently been promoted as an alternative dietary approach for optimal weight management. OBJECTIVE: This study assessed the effectiveness of INT-B compared with that of conventional continuous energy restriction (CER) for improving body composition and attenuating metabolic adaptation. DATA SOURCES: A systematic search was conducted on 6 databases using all available records until July 2023. DATA EXTRACTION: The extracted data included the lead author, year of publication, population characteristics, intervention protocols, duration, and adherence. DATA ANALYSIS: Random-effects meta-analyses were conducted for within-group and between-group comparisons of anthropometric and metabolic outcomes. Subgroup moderator analysis was performed for the types of INT-B, intervention duration, and population characteristics. RESULTS: Of the 1469 records, 12 randomized trials (with 881 participants) were included. Within-group analyses demonstrated significant improvements in body mass, fat mass, body mass index, body fat percentage, and waist circumference following both INT-B and CER, with no significant group differences. However, resting metabolic rate (RMR) was significantly reduced following CER only. The compensatory reduction in RMR was significantly smaller following INT-B compared with CER, suggesting a lesser degree of metabolic adaptation. INT-B had a more significant effect on RMR retention in individuals with overweight/obesity compared with resistance-trained individuals. CONCLUSION: This review provides up-to-date evidence for INT-B as a viable dietary strategy to improve body composition and attenuate metabolic adaptation. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42023448959.