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Colorectal cancer (CRC) is characterized by a complex tumor inflammatory microenvironment, while angiogenesis and immunosuppression frequently occur concomitantly. However, the exact mechanism that controls angiogenesis and immunosuppression in CRC microenvironment remains unclear. Herein, we found that expression levels of lipid raft protein STOML2 were increased in CRC and were associated with advanced disease stage and poor survival outcomes. Intriguingly, we revealed that STOML2 is essential for CRC tumor inflammatory microenvironment, which induces angiogenesis and facilitates tumor immune escape simultaneously both in vitro and in vivo. Moreover, tumors with STOML2 overexpression showed effective response to anti-angiogenesis treatment and immunotherapy in vivo. Mechanistically, STOML2 regulates CRC proliferation, angiogenesis, and immune escape through activated NF-κB signaling pathway via binding to TRADD protein, resulting in upregulation of CCND1, VEGF, and PD-L1. Furthermore, treatment with NF-κB inhibitor dramatically reversed the ability of proliferation and angiogenesis. Clinically, we also observed a strong positive correlation between STOML2 expression and Ki67, CD31, VEGFC and PD-1 of CD8+T cell expression. Taken together, our results provided novel insights into the role of STOML2 in CRC inflammatory microenvironment, which may present a therapeutic opportunity for CRC.
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Neoplasias Colorretais , Proteínas de Membrana , NF-kappa B , Microambiente Tumoral , Humanos , Linhagem Celular Tumoral , Neoplasias Colorretais/metabolismo , NF-kappa B/metabolismo , Transdução de Sinais , Regulação para Cima , Microdomínios da Membrana , Proteínas de Membrana/genéticaRESUMO
The common dolphin (Delphinus delphis) is widely distributed worldwide and well adapted to various habitats. Animal genomes store clues about their pasts, and can reveal the genes underlying their evolutionary success. Here, we report the first high-quality chromosome-level genome of D. delphis. The assembled genome size was 2.56 Gb with a contig N50 of 63.85 Mb. Phylogenetically, D. delphis was close to Tursiops truncatus and T. aduncus. The genome of D. delphis exhibited 428 expanded and 1,885 contracted gene families, and 120 genes were identified as positively selected. The expansion of the HSP70 gene family suggested that D. delphis has a powerful system for buffering stress, which might be associated with its broad adaptability, longevity, and detoxification capacity. The expanded IFN-α and IFN-ω gene families, as well as the positively selected genes encoding tripartite motif-containing protein 25, peptidyl-prolyl cis-trans isomerase NIMA-interacting 1, and p38 MAP kinase, were all involved in pathways for antiviral, anti-inflammatory, and antineoplastic mechanisms. The genome data also revealed dramatic fluctuations in the effective population size during the Pleistocene. Overall, the high-quality genome assembly and annotation represent significant molecular resources for ecological and evolutionary studies of Delphinus and help support their sustainable treatment and conservation.
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Golfinhos Comuns , Animais , Evolução Biológica , Cromossomos/genética , Imunidade Inata/genética , FilogeniaRESUMO
The development of energy- and time-saving synthetic methods to prepare bifunctional and high stability catalysts are vital for overall water splitting. Here, V-doped nickel-iron hydroxide precursor by etching NiFe foam (NFF) at room temperature with dual chloride solution ("NaCl-VCl3"), is obtained then phosphating to obtain V-Ni2P-FeP/NFF as efficient bifunctional (oxygen/hydrogen exchange reaction, OER/HER) electrocatalysts, denoted as NFF(V, Na)-P. The NFF(V, Na)-P requires only 185 and 117 mV overpotentials to reach 10 mA cm-2 for OER and HER. When used as a catalyst for water splitting in a full cell, it can be stably sustained for more than 1000 h in alkaline brine electrolysis at both current densities of 100 and 500 mA cm-2. In situ Raman analyses and density functional theory (DFT) show that the V-doping-induced surface remodeling generates hydroxyl oxides as the true catalytic active centers, which not only enhances the reaction kinetics, but also reduces the free energy change in the rate-determining step. This work provides a cost-effective substrate self-derivation method to convert commercial NFF into a powerful catalyst for electrolytic brine, offering a unique route to the development of efficient electrocatalysts for saline water splitting.
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Oil-water separation based on superwettable materials offers a promising way for the treatment of oil-water mixtures and emulsions. Nevertheless, such separation techniques often require complex devices and external energy input. Therefore, it remains a great challenge to separate oil-water mixtures and emulsions through an energy-efficient, economical, and sustainable way. Here, a novel approach demonstrating the successful separation of oil-water emulsions using antigravity-driven autonomous superwettable pumps is presented. By transitioning from traditional gravity-driven to antigravity-driven separation, the study showcases the unprecedented success in purifying oil/water from emulsions by capillary/siphon-driven superwettable autonomous pumps. These pumps, composed of self-organized interconnected channels formed by the packing of superhydrophobic and superhydrophilic sand particles, exhibit outstanding separation flux, efficiency, and recyclability. The findings of this study not only open up a new avenue for oil-water emulsion separation but also hold promise for profound impacts in the field.
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Bacterial infections still pose a severe threat to public health, necessitating novel tools for real-time analysis of microbial behaviors in living organisms. While genetically engineered strains with fluorescent or luminescent reporters are commonly used in tracking bacteria, their inâ vivo uses are often limited. Here, we report a near-infrared fluorescent D-amino acid (FDAA) probe, Cy7ADA, for inâ situ labeling and intravital imaging of bacterial infections in mice. Cy7ADA probe effectively labels various bacteria inâ vitro and pathogenic Staphylococcus aureus in mice after intraperitoneal injection. Because of Cy7's high tissue penetration and the quick excretion of free probes via urine, real-time visualization of the pathogens in a liver abscess model via intravital confocal microscopy is achieved. The biodistributions, including their intracellular localization within Kupffer cells, are revealed. Monitoring bacterial responses to antibiotics also demonstrates Cy7ADA's capability to reflect the bacterial load dynamics within the host. Furthermore, Cy7ADA facilitates three-dimensional pathogen imaging in tissue-cleared liver samples, showcasing its potential for studying the biogeography of microbes in different organs. Integrating near-infrared FDAA probes with intravital microscopy holds promise for wide applications in studying bacterial infections inâ vivo.
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Corantes Fluorescentes , Staphylococcus aureus , Animais , Corantes Fluorescentes/química , Corantes Fluorescentes/síntese química , Camundongos , Carbocianinas/química , Aminoácidos/química , Infecções Estafilocócicas/diagnóstico por imagem , Infecções Estafilocócicas/microbiologia , Microscopia Intravital/métodos , Imagem Óptica , Infecções Bacterianas/diagnóstico por imagem , Infecções Bacterianas/microbiologia , Raios InfravermelhosRESUMO
Pseudorabies virus (PRV), the causative pathogen of Aujeszky's disease, is one of the most important pathogens threatening the global pig industry. Although vaccination has been used to prevent PRV infection, the virus cannot be eliminated in pigs. Thus, novel antiviral agents as complementary to vaccination are urgently needed. Cathelicidins (CATHs) are host defense peptides that play an important role in the host immune response against microbial infections. In the study, we found that the chemical synthesized chicken cathelicidin B1 (CATH-B1) could inhibit PRV regardless of whether CATH-B1 was added pre-, co-, or post-PRV infection in vitro and in vivo. Furthermore, coincubation of CATH-B1 with PRV directly inactivated virus infection by disrupting the virion structure of PRV and mainly inhibited virus binding and entry. Importantly, pretreatment of CATH-B1 markedly strengthened the host antiviral immunity, as indicated by the increased expression of basal interferon-ß (IFN-ß) and several IFN-stimulated genes (ISGs). Subsequently, we investigated the signaling pathway responsible for CATH-B1-induced IFN-ß production. Our results showed that CATH-B1 induced phosphorylation of interferon regulatory transcription factor 3 (IRF3) and further led to production of IFN-ß and reduction of PRV infection. Mechanistic studies revealed that the activation of Toll-like receptor 4 (TLR4), endosome acidification, and the following c-Jun N-terminal kinase (JNK) was responsible for CATH-B1-induced IRF3/IFN-ß pathway activation. Collectively, CATH-B1 could markedly inhibit PRV infection via inhibiting virus binding and entry, direct inactivation, and regulating host antiviral response, which provided an important theoretical basis for the development of antimicrobial peptide drugs against PRV infection. IMPORTANCE Although the antiviral activity of cathelicidins could be explained by direct interfering with the viral infection and regulating host antiviral response, the specific mechanism of cathelicidins regulating host antiviral response and interfering with pseudorabies virus (PRV) infection remains elusive. In this study, we investigated the multiple roles of cathelicidin CATH-B1 against PRV infection. Our study showed that CATH-B1 could suppress the binding and entry stages of PRV infection and direct disrupt PRV virions. Remarkably, CATH-B1 significantly increased basal interferon-ß (IFN-ß) and IFN-stimulated gene (ISG) expression levels. Furthermore, TLR4/c-Jun N-terminal kinase (JNK) signaling was activated and involved in IRF3/IFN-ß activation in response to CATH-B1. In conclusion, we elucidate the mechanisms by which the cathelicidin peptide direct inactivates PRV infection and regulates host antiviral IFN-ß signaling.
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Herpesvirus Suídeo 1 , Pseudorraiva , Suínos , Animais , Herpesvirus Suídeo 1/metabolismo , Catelicidinas/uso terapêutico , Receptor 4 Toll-Like , Interferon beta/metabolismo , Antivirais/farmacologiaRESUMO
OBJECTIVES: To investigate the effect of the L-arginine metabolism on arthritis and inflammation-mediated bone loss. METHODS: L-arginine was applied to three arthritis models (collagen-induced arthritis, serum-induced arthritis and human TNF transgenic mice). Inflammation was assessed clinically and histologically, while bone changes were quantified by µCT and histomorphometry. In vitro, effects of L-arginine on osteoclast differentiation were analysed by RNA-seq and mass spectrometry (MS). Seahorse, Single Cell ENergetIc metabolism by profilIng Translation inHibition and transmission electron microscopy were used for detecting metabolic changes in osteoclasts. Moreover, arginine-associated metabolites were measured in the serum of rheumatoid arthritis (RA) and pre-RA patients. RESULTS: L-arginine inhibited arthritis and bone loss in all three models and directly blocked TNFα-induced murine and human osteoclastogenesis. RNA-seq and MS analyses indicated that L-arginine switched glycolysis to oxidative phosphorylation in inflammatory osteoclasts leading to increased ATP production, purine metabolism and elevated inosine and hypoxanthine levels. Adenosine deaminase inhibitors blocking inosine and hypoxanthine production abolished the inhibition of L-arginine on osteoclastogenesis in vitro and in vivo. Altered arginine levels were also found in RA and pre-RA patients. CONCLUSION: Our study demonstrated that L-arginine ameliorates arthritis and bone erosion through metabolic reprogramming and perturbation of purine metabolism in osteoclasts.
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Artrite Experimental , Artrite Reumatoide , Reabsorção Óssea , Humanos , Camundongos , Animais , Osteoclastos , Artrite Reumatoide/patologia , Artrite Experimental/patologia , Inflamação/metabolismo , Camundongos Transgênicos , Arginina/farmacologia , Inosina/metabolismo , Inosina/farmacologia , Hipoxantinas/metabolismo , Hipoxantinas/farmacologia , Purinas/farmacologiaRESUMO
BACKGROUND: Adenomatous polyps (APs) with inflammation are risk factors for colorectal cancer. However, the role of inflammation-related gut microbiota in promoting the progression of APs is unknown. METHODS: Sequencing of the 16S rRNA gene was conducted to identify characteristic bacteria in AP tissues and normal mucosa. Then, the roles of inflammation-related bacteria were clarified by Spearman correlation analysis. Furthermore, colorectal HT-29 cells, normal colon NCM460 cells, and azoxymethane-treated mice were used to investigate the effects of the characteristic bacteria on progression of APs. RESULTS: The expression levels of inflammation-related markers (diamine oxidase, D-lactate, C-reactive protein, tumor necrosis factor-α, interleukin-6 and interleukin-1ß) were increased, whereas the expression levels of anti-inflammatory factors (interleukin-4 and interleukin-10) were significantly decreased in AP patients as compared to healthy controls. Solobacterium moorei (S. moorei) was enriched in AP tissues and fecal samples, and significantly positively correlated with serum inflammation-related markers. In vitro, S. moorei preferentially attached to HT-29 cells and stimulated cell proliferation and production of pro-inflammatory factors. In vivo, the incidence of intestinal dysplasia was significantly increased in the S. moorei group. Gavage of mice with S. moorei upregulated production of pro-inflammatory factors, suppressed proliferation of CD4+ and CD8+cells, and disrupted the integrity of the intestinal barrier, thereby accelerating progression of APs. CONCLUSIONS: S. moorei accelerated the progression of AP in mice via activation of the NF-κB signaling pathway, chronic low-grade inflammation, and intestinal barrier disruption. Targeted reduction of S. moorei presents a potential strategy to prevent the progression of APs.
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Pólipos Adenomatosos , Firmicutes , Humanos , Animais , Camundongos , RNA Ribossômico 16S/genética , Inflamação/complicações , Pólipos Adenomatosos/complicaçõesRESUMO
Severe dry eye (SDE) can cause grievous damage to the ocular surface and result in vision impairment and even blindness. To investigate the fate of limbal stem cells in SDE and the underlying mechanism, the current study established an SDE rat model by removing the extraorbital and infraorbital lacrimal glands and maintaining them in a low-humidity environment. One month after the surgery, aqueous tear secretion was reduced dramatically, blood vessels invaded into the central cornea, and inflammatory cells infiltrated into the limbal stroma. The expressions of keratin 12 and paired box gene 6 were down-regulated dramatically, while those of keratin 10, small proline-rich protein 1b, and mucin 5AC were up-regulated in the corneal epithelium of the SDE rats. Cell proliferation in the limbal epithelium was up-regulated, while the stem/progenitor marker adenosine 5'-triphosphate-binding cassette member 2 and the limbal epithelial colony-forming efficiency were decreased in the SDE condition. Furthermore, the p38 mitogen-activated protein kinase signaling pathway was activated in the limbal corneal epithelium of SDE rats. The abnormal differentiation and stemness loss in the corneal epithelium could be reversed upon treatment with a p38 inhibitor in a SDE in vivo model and in vitro hyperosmolar corneal epithelial culture conditions. These data suggest that SDE can lead to limbal stem cell dysfunction, and p38 mitogen-activated protein kinase signaling pathway activation plays an essential role in this process.
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Phaeodactylum tricornutum a prominent source of industrial fucoxanthin production, faces challenges in its application due to its tolerance to high-temperature environments. This study investigates the physiological responses of P. tricornutum to high-temperature stress and its impact on fucoxanthin content, with a specific focus on the role of cis-zeatin. The results reveal that high-temperature stress inhibits P. tricornutum's growth and photosynthetic activity, leading to a decrease in fucoxanthin content. Transcriptome analysis shows that high temperature suppresses the expression of genes related to photosynthesis (e.g., psbO, psbQ, and OEC) and fucoxanthin biosynthesis (e.g., PYS, PDS1, and PSD2), underscoring the negative effects of high temperature on P. tricornutum. Interestingly, genes associated with cis-zeatin biosynthesis and cytokinesis signaling pathways exhibited increased expression under high-temperature conditions, indicating a potential role of cis-zeatin signaling in response to elevated temperatures. Content measurements confirm that high temperature enhances cis-zeatin content. Furthermore, the exogenous addition of cytokinesis mimetics or inhibitors significantly affected P. tricornutum's high-temperature resistance. Overexpression of the cis-zeatin biosynthetic enzyme gene tRNA DMATase enhanced P. tricornutum's resistance to high-temperature stress, while genetic knockout of tRNA DMATase reduced its resistance to high temperatures. Therefore, this research not only uncovers a novel mechanism for high-temperature resistance in P. tricornutum but also offers a possible alga species that can withstand high temperatures for the industrial production of fucoxanthin, offering valuable insights for practical utilization.IMPORTANCEThis study delves into Phaeodactylum tricornutum's response to high-temperature stress, specifically focusing on cis-zeatin. We uncover inhibited growth, reduced fucoxanthin, and significant cis-zeatin-related gene expression under high temperatures, highlighting potential signaling mechanisms. Crucially, genetic engineering and exogenous addition experiments confirm that the change in cis-zeatin levels could influence P. tricornutum's resistance to high-temperature stress. This breakthrough deepens our understanding of microalgae adaptation to high temperatures and offers an innovative angle for industrial fucoxanthin production. This research is a pivotal step toward developing heat-resistant microalgae for industrial use.
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Diatomáceas , Temperatura Alta , Xantofilas , Xantofilas/metabolismo , Diatomáceas/metabolismo , Diatomáceas/genética , Diatomáceas/crescimento & desenvolvimento , FotossínteseRESUMO
Myeloproliferative neoplasm (MPN) usually has an adverse prognosis, progressing to acute leukemia or splanchnic vein thromboses (SVTs). Therefore, early diagnosis and intervention are significantly important. Clinically, the burden of JAK2V617F is a vital diagnostic basis, which can be detected during the early stage of MPN. Thus, an accurate and rapid detective technique is urgently required. In recent years, real-time quantitative PCR (qPCR) has primarily been applied to detect the copies of JAK2V617F, whereas droplet digital PCR (ddPCR), a novel and promising detective tool, can conduct precise and repeatable quantification of nucleic acid copies without relying on the standard curve. In our study, both qPCR and ddPCR are used to evaluate the mutation burden of JAK2V617F in a series of gradient diluted standards and clinical JAK2V617F-positive MPN patients' bone marrow samples collected, while using next-generation sequencing technology (NGS) as a contrast. With the help of statistical methods, our study concluded that ddPCR had a better performance in accuracy, sensitivity, and stability, especially in a low burden. Regarding the accuracy, ddPCR showed a better linearity (Pearson R2 = 0.9926; P < 0.0001) than qPCR (Pearson R2 = 0.9772; P < 0.0001). What is more, ddPCR showed lower intra-assay and inter-assay CVs and the limit of detection (LOD) for the series of diluted standards than qPCR, demonstrating better stability and lower LOD. In a nutshell, ddPCR is a more promising technique for the detection and quantification of JAK2V617F.
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Variações do Número de Cópias de DNA , Transtornos Mieloproliferativos , Humanos , Reação em Cadeia da Polimerase em Tempo Real/métodos , Sensibilidade e Especificidade , Limite de Detecção , Transtornos Mieloproliferativos/diagnóstico , Transtornos Mieloproliferativos/genéticaRESUMO
Macrophages, as highly phenotypic plastic immune cells, play diverse roles in different pathological conditions. Changing and controlling the phenotypes of macrophages is considered a novel potential therapeutic intervention. Meanwhile, specific transmembrane proteins anchoring on the surface of the macrophage membrane are relatively conserved, supporting its functional properties, such as inflammatory chemotaxis and tumor targeting. Thus, a series of drug delivery systems related to specific macrophage membrane proteins are commonly used to treat chronic inflammatory diseases. This review summarizes macrophages-based strategies for chronic diseases, discusses the regulation of macrophage phenotypes and their polarization processes, and presents how to design and apply the site-specific targeted drug delivery systems in vivo based on the macrophages and their derived membrane receptors. It aims to provide a better understanding of macrophages in immunoregulation and proposes macrophages-based targeted therapeutic approaches for chronic diseases.
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Sistemas de Liberação de Medicamentos , Neoplasias , Humanos , Fenótipo , Macrófagos/metabolismo , Neoplasias/tratamento farmacológico , Neoplasias/metabolismo , Doença CrônicaRESUMO
Obstructive sleep apnea (OSA) is commonly observed in children with Down syndrome (DS) and may affect their physical and psychological development. Currently, adenotonsillectomy is the first line treatment option for paediatric patients with OSA. However, surgical outcomes for such patients are not satisfactory. In this study, we analysed the efficacy and safety of adenotonsillectomy in the treatment of children with obstructive sleep apnea and Down syndrome. We systematically searched the PubMed, Web of Science, EMBASE, and the Cochrane databases and pooled data from nine relevant studies involving 384 participants. Subsequently, we analysed four outcomes in polysomnography, namely: net postoperative changes in the apnea-hypopnea index (AHI), the minimum oxygen saturation, sleep efficiency, and arousal index. Meta-analysis of the AHI showed a decrease of 7.18 events/h [95% CI (-9.69, -4.67) events/h; p < 0.00001] and an increase in the minimum oxygen saturation of 3.14% [95% CI (1.44, 4.84) %; p = 0.0003]. There was no significant increase in sleep efficiency [MD 1.69%, 95% CI (-0.59, 3.98) %; p = 0.15], but the arousal index significantly decreased by -3.21 events/hour [95% CI (-6.04, -0.38) events/h; p < 0.03]. In addition, the overall success rate was 16% (95% CI, 12%-21%) for postoperative AHI < 1 and 57% (95% CI, 51%-63%) for postoperative AHI <5. The postoperative complications recorded included airway obstruction and bleeding. This study demonstrated the efficacy of adenotonsillectomy as a treatment option for OSA. However, it is important to note that residual OSA and potential postoperative complications require further attention in future studies.
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Síndrome de Down , Apneia Obstrutiva do Sono , Tonsilectomia , Criança , Humanos , Síndrome de Down/complicações , Síndrome de Down/cirurgia , Resultado do Tratamento , Tonsilectomia/efeitos adversos , Apneia Obstrutiva do Sono/complicações , Apneia Obstrutiva do Sono/cirurgia , Complicações Pós-Operatórias/cirurgiaRESUMO
OBJECTIVES: Fibromyalgia (FM) is a chronic pain disorder that takes a severe physical and psychological toll on patients and severely reduces their quality of life. In recent years, an increasing number of studies have used functional magnetic resonance imaging (fMRI) to investigate its pathogenesis. However, a recent summary analysis of functional connectivity in patients with FM is lacking. METHODS: We searched bibliographic databases, including PubMed, Web of Science (from inception until September 1st, 2022). Two separate researchers assessed the bias and quality of the studies. In order to further explain the core mechanism for FM, the abnormal brain function of FM was investigated by Activation Likelihood Estimation (ALE) analysis. RESULTS: Twenty-six FM publications (1,056 subjects) were eligible to be included in an ALE analysis. We found that the anterior cingulate (ACC) and insula (Ins) were abnormally active in patients with FM. In particular, the peak coordinates of (8,46,4) and (-46, -4,10) correspond to brain regions that were less active than healthy individuals. Furthermore, the Z-values were 4.46 and 4.97, while the p-values were 4.06 and 3.38. Surprisingly, we found that the degree of pain was negatively correlated with the activation of Ins (SDM-Z = -2.714). CONCLUSIONS: This study demonstrates abnormal brain activation which could lead to increased sensitivity of pain in patients with FM. The study sheds light on the central mechanisms of FM and provides the basis for further research.
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Encéfalo , Fibromialgia , Imageamento por Ressonância Magnética , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Encéfalo/fisiopatologia , Encéfalo/diagnóstico por imagem , Mapeamento Encefálico/métodos , Fibromialgia/fisiopatologia , Fibromialgia/psicologia , Fibromialgia/diagnóstico por imagem , Giro do Cíngulo/fisiopatologia , Giro do Cíngulo/diagnóstico por imagem , Córtex Insular/fisiopatologia , Córtex Insular/diagnóstico por imagem , Medição da DorRESUMO
Creating affordable electrocatalysts and understanding the real-time catalytic process of the urea oxidation reaction (UOR) are crucial for advancing urea-based technologies. Herein, a Cu-Ni based selenide electrocatalyst (CuSey/NiSex/NF) was created using a hydrothermal technique and selenization treatment, featuring a heterogeneous interface rich in Cu2-xSe, Cu3Se2, Ni3Se4, and NiSe2. This catalyst demonstrated outstanding urea electrooxidation performance, achieving 10 mA cm-2 with just 1.31 V and sustaining stability for 96 h. Through in-situ Raman spectroscopy and ex-situ characterizations, it is discovered that NiOOH is formed through surface reconstruction in the UOR process, with high-valence Ni serving as the key site for effective urea oxidation. Moreover, the electrochemical analysis revealed that CuSey had dual effects. An analysis of XPS and electrochemical tests revealed that electron transfer from CuSey to NiSex within the CuSey/NiSex/NF heterostructure enhanced the UOR kinetics of the catalyst. Additionally, according to the in-situ Raman spectroscopy findings, the existence of CuSey facilitates a easier and faster surface reconstruction of NiSex, leading to the creation of additional active sites for urea oxidation. More significantly, this work provides an excellent "precatalyst" for highly efficient UOR, along with an in-depth understanding of the mechanism behind the structural changes in electrocatalysts and the discovery of their true active sites.
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Survival models can help medical practitioners to evaluate the prognostic importance of clinical variables to patient outcomes such as mortality or hospital readmission and subsequently design personalized treatment regimes. Electronic Health Records (EHRs) hold the promise for large-scale survival analysis based on systematically recorded clinical features for each patient. However, existing survival models either do not scale to high dimensional and multi-modal EHR data or are difficult to interpret. In this study, we present a supervised topic model called MixEHR-SurG to simultaneously integrate heterogeneous EHR data and model survival hazard. Our contributions are three-folds: (1) integrating EHR topic inference with Cox proportional hazards likelihood; (2) integrating patient-specific topic hyperparameters using the PheCode concepts such that each topic can be identified with exactly one PheCode-associated phenotype; (3) multi-modal survival topic inference. This leads to a highly interpretable survival topic model that can infer PheCode-specific phenotype topics associated with patient mortality. We evaluated MixEHR-SurG using a simulated dataset and two real-world EHR datasets: the Quebec Congenital Heart Disease (CHD) data consisting of 8211 subjects with 75,187 outpatient claim records of 1767 unique ICD codes; the MIMIC-III consisting of 1458 subjects with multi-modal EHR records. Compared to the baselines, MixEHR-SurG achieved a superior dynamic AUROC for mortality prediction, with a mean AUROC score of 0.89 in the simulation dataset and a mean AUROC of 0.645 on the CHD dataset. Qualitatively, MixEHR-SurG associates severe cardiac conditions with high mortality risk among the CHD patients after the first heart failure hospitalization and critical brain injuries with increased mortality among the MIMIC-III patients after their ICU discharge. Together, the integration of the Cox proportional hazards model and EHR topic inference in MixEHR-SurG not only leads to competitive mortality prediction but also meaningful phenotype topics for in-depth survival analysis. The software is available at GitHub: https://github.com/li-lab-mcgill/MixEHR-SurG.
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Registros Eletrônicos de Saúde , Modelos de Riscos Proporcionais , Humanos , Análise de Sobrevida , Algoritmos , Prognóstico , MortalidadeRESUMO
The precise determination of the bond dissociation energy of N2 is crucial for thermochemistry database and theoretical calculations. However, there has been ongoing debate regarding its exact value. In this study, we used the velocity map imaging method combined with an extreme ultraviolet laser to measure the threshold fragment yield (TFY) spectra of N2 in the N(2D) + N(2D) photodissociation channels. By integrating the signals within a small circular area on the fragment velocity map images, we were able to obtain TFY spectra at nine different dissociation thresholds. These spectra are rotational state-resolved for the N2(Jâ³) molecules and spin-orbit state-resolved for the dissociation channels involving N(2D) fragments. By employing the Wigner threshold law to simulate the TFY spectra and conducting statistical analysis on the comprehensive dataset, we determined the N2 bond dissociation energy to be 78 691.09 ± 0.15 cm-1. This work now places N2 among the few diatomic molecules with bond dissociation energies measured at sub-wavenumber precision.
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We conducted a study on the variations of the fragment anisotropy parameters (ß) along the Fano profiles for the predissociation of the D2 molecule. These variations, known as ß profiles, were measured for the D(2l) fragments from the predissociation of the 4pπD'Πu1υ'=1 and 4pσBâ³Σu+1υ'=2 states. The measured ß profiles show significant asymmetry and broader linewidths compared to the corresponding Fano profiles. By fitting the ß profiles, we were able to determine the fragment anisotropy parameters associated with the resonance state, continuum state, and the interference effect between them. Additionally, we determined the ratios of the absorption cross sections between the unperturbed and perturbed continuum states interacting with the resonance states although these ratios were found to be very small. Furthermore, we derived approximate formulas to calculate the parameters characterizing the ß profile. Despite the linewidths of the four Fano profiles being narrower than our instrumental resolution, we were still able to determine the product of the linewidth with the Fano q parameters. These findings demonstrate the utility of the ß profile as an effective tool for studying the predissociation dynamics in diatomic molecules.
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BACKGROUND: The Chinese government has formulated a series of policies and strengthened training of general practitioners (GPs) to support their role as "gatekeepers" of residents' health. This study aimed to explore the core competencies of Chinese GPs and develop a competency framework in line with China's actual conditions, which can provide a more scientific basis for the education, training, and evaluation of GPs. METHODS: Literature analysis and behaviour event interviews were conducted to build the competency dictionary and the initial version of the competency model. Two rounds of Delphi were performed to gain consensus on the final model. The questionnaire survey was carried out in 10 provinces (municipalities, autonomous regions) of China, and GPs were invited to score the importance of each competency item. The total sample was randomly divided into two groups. One group was for exploratory factor analysis (EFA), and the other was for confirmatory factor analysis (CFA) to examine the scale's reliability and validity. RESULTS: The dictionary of general practitioners' competency including 107 competency items was constructed. After two rounds of Delphi, a consensus was reached on 60 competencies in 6 domains. A total of 1917 valid questionnaires were obtained in the nationwide survey. The average importance score of all second-level indicators is 4.53 ± 0.45. The Cronbach's α coefficient is 0.984. The results of the five factors extracted by EFA showing the 68.16% cumulative explained variance variation is considered to be consistent with the six dimensions obtained by Delphi after thorough discussion. The model fitness indexes obtained by CFA were acceptable (χ2/df = 4.909, CFI = 0.869, NFI = 0.841, RMSEA = 0.065). The values of the composite reliability (CR) of the six dimensions were all greater than 0.7 (0.943, 0.927, 0.937, 0.927, 0.943, 0.950), and the average of variance extracted (AVE) were all greater than 0.5 (0.562, 0.613, 0.649, 0.563, 0.626, 0.635). The results showed that the model has good reliability and validity. CONCLUSION: A competency model for GPs suited to China has been developed, which may offer guidance for future training and medical licensing examinations of GPs.
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Competência Clínica , Técnica Delphi , Clínicos Gerais , Humanos , Competência Clínica/normas , China , Inquéritos e Questionários , Masculino , Feminino , Reprodutibilidade dos Testes , Adulto , Pessoa de Meia-Idade , Análise Fatorial , ConsensoRESUMO
PURPOSE: The purpose of this study was to investigate the impact of autofluorescence technology on postoperative parathyroid function and short-term outcomes in patients undergoing thyroid surgery. METHODS: A total of 546 patients were included in the study, with 287 in the conventional treatment group and 259 in the autofluorescence group. Both groups underwent central lymph node dissection, which is known to affect parathyroid function. Short-term outcomes, including rates of postoperative hypocalcemia and parathyroid dysfunction, serum calcium and PTH levels on the first postoperative day, as well as the need for calcium supplementation, were analyzed. A multivariable analysis was also conducted to assess the impact of autofluorescence on postoperative parathyroid dysfunction, considering factors such as age, BMI, and preoperative calcium levels. RESULTS: The autofluorescence group demonstrated significantly lower rates of postoperative hypocalcemia and parathyroid dysfunction compared to the conventional treatment group. The autofluorescence group also had better serum calcium and PTH levels on the first postoperative day, and a reduced need for calcium supplementation. Surprisingly, the use of autofluorescence technology did not prolong surgical time; instead, it led to a shorter hospitalization duration. The multivariable analysis showed that autofluorescence significantly reduced the risk of postoperative parathyroid dysfunction, while factors such as age, BMI, and preoperative calcium levels did not show a significant correlation. CONCLUSION: This study provides evidence that autofluorescence technology can improve the preservation of parathyroid function during thyroid surgery, leading to better short-term outcomes and reduced postoperative complications. The findings highlight the potential of autofluorescence as a valuable tool in the management of parathyroid hypofunction. Further research and validation are needed to establish the routine use of autofluorescence technology in the thyroid.