Air pollution, genetic susceptibility, and the risk of atrial fibrillation: A large prospective cohort study.

To date, no study has explored the extent to which genetic susceptibility modifies the effects of air pollutants on the risk of atrial fibrillation (AF). This study was designed to investigate the separate and joint effects of long-term exposure to air pollutants and genetic susceptibility on the risk of AF events. This study included 401,251 participants without AF at baseline from UK Biobank. We constructed a polygenic risk score and categorized it into three categories. Cox proportional hazards models were fitted to assess the separate and joint effects of long-term exposure to air pollutants and genetics on the risk of AF. Additionally, we further evaluated the effect modification of genetic susceptibility. The hazard ratios and corresponding 95% confidence intervals of incident AF for per interquartile range increase in particulate matter with an aerodynamic diameter smaller than 2.5 µm (PM2.5) or 10 µm (PM10), nitrogen dioxide (NO2), and nitrogen oxide (NOx) were 1.044 (1.025, 1.063), 1.063 (1.044, 1.083), 1.061 (1.042, 1.081), and 1.039 (1.023, 1.055), respectively. For the combined effects, participants exposed to high air pollutants levels and high genetic risk had approximately 149.2% (PM2.5), 181.7% (PM10), 170.2% (NO2), and 157.2% (NOx) higher risk of AF compared to those with low air pollutants levels and low genetic risk, respectively. Moreover, the significant additive interactions between PM10 and NO2 and genetic risk on AF risk were observed, with around 16.4% and 35.1% of AF risk could be attributable to the interactive effects. In conclusion, long-term exposure to air pollutants increases the risk of AF, particularly among individuals with high genetic susceptibility.

Incompatible and sterile insect techniques combined eliminate mosquitoes.

The radiation-based sterile insect technique (SIT) has successfully suppressed field populations of several insect pest species, but its effect on mosquito vector control has been limited. The related incompatible insect technique (IIT)-which uses sterilization caused by the maternally inherited endosymbiotic bacteria Wolbachia-is a promising alternative, but can be undermined by accidental release of females infected with the same Wolbachia strain as the released males. Here we show that combining incompatible and sterile insect techniques (IIT-SIT) enables near elimination of field populations of the world's most invasive mosquito species, Aedes albopictus. Millions of factory-reared adult males with an artificial triple-Wolbachia infection were released, with prior pupal irradiation of the released mosquitoes to prevent unintentionally released triply infected females from successfully reproducing in the field. This successful field trial demonstrates the feasibility of area-wide application of combined IIT-SIT for mosquito vector control.

HLA-C*07:01 and HLA-DQB1*02:01 protect against white matter hyperintensities and deterioration of cognitive function: A population-based cohort study.

BACKGROUND: Neuroinflammation and aberrant immune regulation are increasingly implicated in the pathophysiology of white matter hyperintensities (WMH), an imaging marker of cerebrovascular pathologies and predictor of cognitive impairment. The role of human leukocyte antigen (HLA) genes, critical in immunoregulation and associated with susceptibility to neurodegenerative diseases, in WMH pathophysiology remains unexplored. METHODS: We performed association analyses between classical HLA alleles and WMH volume, derived from MRI scans of 38 302 participants in the UK Biobank. To identify independent functional alleles driving these associations, we conducted conditional forward stepwise regression and lasso regression. We further investigated whether these functional alleles showed consistent associations with WMH across subgroups characterized by varying levels of clinical determinants. Additionally, we validated the clinical relevance of the identified alleles by examining their association with cognitive function (n = 147 549) and dementia (n = 460 029) in a larger cohort. FINDINGS: Four HLA alleles (DQB1*02:01, DRB1*03:01, C*07:01, and B*08:01) showed an association with reduced WMH volume after Bonferroni correction for multiple comparisons. Among these alleles, DQB1*02:01 exhibited the most significant association (ß = -0.041, 95 % CI: -0.060 to -0.023, p = 1.04 × 10-5). Forward selection and lasso regression analyses indicated that DQB1*02:01 and C*07:01 primarily drove this association. The protective effect against WMH conferred by DQB1*02:01 and C*07:01 persisted in clinically relevant subgroups, with a stronger effect observed in older participants. Carrying DQB1*02:01 and C*07:01 was associated with higher cognitive function, but no association with dementia was found. INTERPRETATION: Our population-based findings support the involvement of immune-associated mechanisms, particularly both HLA class I and class II genes, in the pathogenesis of WMH and subsequent consequence of cognitive functions.

The long-term changing patterns of suicide mortality in China from 1987 to 2020: continuing urban-rural disparity.

BACKGROUND: Over the past three decades, China has experienced significant changes in urban-rural, gender, and age-specific suicide mortality patterns. This study aimed to investigate the long-term trends in suicide mortality in China from 1987 to 2020. METHODS: Suicide mortality data were obtained from China's National Health Commission. Joinpoint regression analysis was used to examine changes in trends and age-period-cohort modeling to estimate age, period, and cohort effects on suicide mortality from 1987 to 2020. Net drift, local drift, longitudinal age curves, and period relative risks were also calculated. RESULTS: Crude and age-standardized suicide mortality in China showed continuing downward trends from 1987 to 2020, with a more pronounced decrease in rural areas (net drift = -7.07%, p<0.01) compared to urban areas (net drift = -3.41%, p<0.01). The decline curve of urban areas could be divided into three substages. Period and cohort effects were more prominent in rural areas. Suicide risk was highest among individuals aged 20-24 and gradually increased after age 60. Females, particularly those of childbearing age, had higher suicide risk than males, with a reversal observed after age 50. This gender reversal showed distinct patterns in urban and rural areas, with a widening gap in urban areas and a relatively stable gap in rural areas. CONCLUSIONS: Suicide mortality in China has consistently declined over the past three decades. However, disparities in age, gender, and urban-rural settings persist, with new patterns emerging. Targeted suicide prevention programs are urgently needed for high-risk groups, including females of childbearing age and the elderly, and to address the slower decrease and reversing urban-rural gender trends.

Efficient Meta-couplers Squeezing Propagating Light into On-Chip Subwavelength Devices in a Controllable Way.

On-chip photonic systems play crucial roles in nanoscience and nanoapplications, but coupling external light to these subwavelength devices is challenging due to a large mode mismatch. Here, we establish a new scheme for realizing highly miniaturized couplers for efficiently exciting on-chip photonic devices in a controllable way. Relying on both resonant and Pancharatnam-Berry mechanisms, our meta-device can couple circularly polarized light to a surface plasmon, which is then focused into a spot placed with a target on-chip device. We experimentally demonstrate two meta-couplers. The first can excite an on-chip waveguide (with a 0.1λ × 0.2λ cross section) with an absolute efficiency of 51%, while the second can achieve incident spin-selective excitation of a dual-waveguide system. Background-free excitation of a gap-plasmon nanocavity with the local field enhanced by >1000 times is numerically demonstrated. Such a scheme connects efficiently propagating light in free space and localized fields in on-chip devices, being highly favored in many integration-optics applications.

High-efficiency plasmonic vortex generation with near-infrared bifunctional metasurfaces.

Plasmonic vortices have shown a wide range of applications in on-chip photonics due to their fascinating properties of the orbital angular momenta (OAM) and phase singularity. However, conventional devices to generate them suffer from issues of low efficiencies and limited functionalities. Here, we establish a systematic scheme to construct high-efficiency bifunctional metasurfaces that can generate two plasmonic vortices exhibiting distinct topological charges, based on a series of reflective meta-atoms exhibiting tailored reflection-phases dictated by both resonant and geometric origins. As a benchmark test, we first construct a meta-coupler with meta-atoms exhibiting geometric phases only, and experimentally demonstrate that it can generate a pre-designed plasmonic vortex at the wavelength of 1064 nm with an efficiency of 27% (56% in simulation). Next, we design/fabricate two bifunctional metasurfaces with meta-atoms integrated with both resonant and geometric phases, and experimentally demonstrate that they can generate divergent (or focused) or convergent (or defocused) plasmonic vortices with district OAM as shined by circularly polarized light with opposite helicity at 1064 nm wavelength. Our work provides an efficient platform to generate plasmonic vortices as desired, which can find many applications in on-chip photonics.

What's in a Name? Terminology Preferences Among Patients Receiving Methadone Treatment.

BACKGROUND: Despite recognition of the importance of substance use disorder (SUD) terminology, few studies examine terminology preferences among patients with SUDs. OBJECTIVE: To examine preferences of patients with opioid use disorder (OUD) concerning the terminology used by addiction counselors. DESIGN: From January 1, 2019, to February 28, 2020, participants were recruited consecutively from 30-day treatment review sessions at outpatient methadone treatment programs in the Northeastern United States to complete a cross-sectional survey. PARTICIPANTS: Participants were English-speaking adult patients with OUD enrolled in methadone treatment. MAIN MEASURES: Participants completed 7-point Likert-type scales from 1 ("Strongly Disagree") to 7 ("Strongly Agree") to rate their preferences for (a) the presenting problem, (b) collective nouns referring to those with the presenting problem, and (c) personal descriptors. We used univariate analysis of covariance (ANCOVA) to examine the associations between demographics (i.e., age, sex, and race) and terminology preferences and ordinal logit regression to explore the association between 12-step program partiality and preference for the term "addict." KEY RESULTS: We surveyed 450 patients with mean age of 38.5 (SD = 11.1) years; 59.6% self-identified as male, 77.6% as White, and 12.7% as Hispanic. The highest-rated preferences for presenting problem were "addiction," "substance use," and "substance abuse." The highest-rated collective noun terms were "client," "patient," and "guest." "Person with an addiction," "person with substance use disorder," and "substance-dependent person" were the highest-rated personal descriptors. There were significant differences in terminological preference based on race and age. Twelve-step program partiality was associated with greater preference for the term "addict" (F = 21.22, p < .001). CONCLUSIONS: Terminology preferences among people receiving methadone treatment aligned with existing guidelines recommending that clinicians use medically accurate and destigmatizing terminology when referring to substance use disorders and the persons who have them. Demographic differences emerged in terminological preferences, warranting further examination.

Hybrid Carbon Sphere Chain-MnO2 Nanorods as Bifunctional Oxygen Electrocatalysts for Rechargeable Zinc-Air Batteries.

It is now recognized that the development of self-supported and efficient bifunctional air cathodes via the direct growth of earth-abundant catalysts onto the surface of the conductive collector would be a cutting-edge strategy to reduce interfacial resistance, enhance the mechanical tenure, and reduce the final weight and cost of manufacturing of rechargeable Zn-air batteries (ZABs). This work reports an innovative self-supported precious metal-free electrode, comprising carbon sphere chains (CSCs) directly grown onto a carbon paper (CP) substrate, wherein the CSCs have a functionalized surface bearing carbon nanobud defects, oxygen functional groups, and high-density MnO2 hierarchical nanorods (NRs), uniformly coating the surface of CSCs. Not only is the metal-free functionalized CSC catalyst functional for both the oxygen reduction reaction (ORR) and the oxygen evolution reaction (OER) but its combination with MnO2 NRs impressively enhances the ORR/OER activities. A homemade ZAB assembled with functionalized CSC/MnO2 air cathode can successfully power a timer for a period of 17 days with no voltage loss, whereas two series-connected ZABs can light up 39 red light-emitting diode (LED) bulbs. The self-supported and earth-abundant-based CSC/MnO2 materials open up an opportunity for lightweight and cost-effective ZABs and metal-air batteries in general.

Temperature variability and common diseases of the elderly in China: a national cross-sectional study.

BACKGROUND: In the context of climate change, it has been well observed that short-term temperature variability (TV) could increase the overall and cause-specific mortality and morbidity. However, the association between long-term TV and a broader spectrum of diseases is not yet well understood, especially in the elderly. METHODS: Our study used data from the fourth Urban and Rural Elderly Population (UREP) study. Long-term TV was calculated from the standard deviation (SD) of daily minimum and maximum temperatures within the study periods (2010-2014, 2011-2014, 2012-2014, 2013-2014, and 2014). Ten self-reported diseases and conditions were collected by questionnaire, including cataract, hypertension, diabetes, cardio-cerebrovascular diseases, stomach diseases, arthritis, chronic lung disease, asthma, cancer, and reproductive diseases. The province-stratified logistic regression model was used to quantify the association between long-term TV and the prevalence of each disease. RESULTS: A total of 184,047 participants were included in our study. In general, there were significant associations between TV and the prevalence of most diseases at the national level. Cardio-cerebrovascular disease (OR: 1.16, 95% CI: 1.13, 1.20) generated the highest estimates, followed by stomach diseases (OR: 1.15, 95% CI: 1.10, 1.19), asthma (OR: 1.14, 95% CI: 1.06, 1.22), chronic lung diseases (OR: 1.08, 95% CI: 1.03, 1.13), arthritis (OR: 1.08, 95% CI: 1.05, 1.11), and cataract (OR: 1.06, 95% CI: 1.02, 1.10). Moreover, the associations varied by geographical regions and across subgroups stratified by sex, household income, physical activity, and education. CONCLUSIONS: Our study showed that long-term exposure to TV was associated with the prevalence of main diseases in the elderly. More attention should be paid to the elderly and targeted strategies should be implemented, such as an early warning system.

The impact of body image dissatisfaction on psychological distress and health-related quality of life among patients in methadone treatment.

BACKGROUND AND OBJECTIVES: Minimal research has examined body image dissatisfaction (BID) among patients receiving methadone maintenance treatment (MMT). We tested associations between BID and MMT quality indicators (psychological distress, mental and physical health-related quality of life [HRQoL]) and whether these associations varied by gender. METHODS: One hundred and sixty-four participants (n = 164) in MMT completed self-report measures of body mass index (BMI), BID, and MMT quality indicators. General linear models tested if BID was associated with MMT quality indicators. RESULTS: Patients were primarily non-Hispanic White (56%) men (59%) with an average BMI in the overweight range. Approximately 30% of the sample had moderate or marked BID. Women and patients with a BMI in the obese range reported higher BID than men and patients with normal weight, respectively. BID was associated with higher psychological distress, lower physical HRQoL, and was unrelated to mental HRQoL. However, there was a significant interaction in which the association between BID and lower mental HRQoL was stronger for men than women. DISCUSSION AND CONCLUSIONS: Moderate or marked BID is present for about three in 10 patients. These data also suggest that BID is tied to important MMT quality indicators, and that these associations can vary by gender. The long-term course of MMT may allow for assessing and addressing novel factors influencing MMT outcomes, including BID. SCIENTIFIC SIGNIFICANCE: This is one of the first studies to examine BID among MMT patients, and it highlights MMT subgroups most at risk for BID and reduced MMT quality indicators due to BID.

New evidence of trends in cognitive function among middle-aged and older adults in China, 2011-2018: an age-period-cohort analysis.

BACKGROUND: Increasing evidence from high-income countries suggests the risk of cognitive impairment has been declining recently. However, related studies in China have rarely been done, and the results are inconsistent. We analyze the trends in cognitive function among middle-aged and older adults in China between 2011 and 2018. METHODS: We used data from four waves of the China Health and Retirement Longitudinal Study (CHARLS), including 48918 individuals aged 45 years and older. Cognitive function was assessed using the CHARLS cognitive measures containing episodic memory, orientation, attention, and visuospatial abilities. The hierarchical age-period-cohort (APC) model was used to quantify the separate age, period, and cohort effects on trends in cognitive function. RESULTS: The study sample's ages ranged from 45 to 105 years (Mean = 59.2, SD = 9.4). Cognitive function declined with age net of period and cohort effects, an apparent acceleration in the rate of cognitive decline after age 65 was found adjusting for individual characteristics. Although period effects on trends in cognitive function remained stable during the study period, hierarchical APC models demonstrated significant cohort variations. Independent of age and period effects, there was a fluctuating trend across cohorts before 1960 and an overall decline across successive cohorts. CONCLUSIONS: Our study indicates that the age effect remains the most crucial factor regarding cognitive decline. Moreover, results demonstrate that cohorts living in social upheaval leading to educational deprivation and/or nutritional deficiency in early life may face a higher risk for cognitive deterioration later in life. Such findings indicate that dementia prevention from a life course perspective and cohort-specific strategies are critical to alleviating the future public-health burdens related to cognitive aging. Ongoing attention should be paid to the role of cross-cohort differences in education on cohort trends in cognition in countries like China that are aging rapidly and have a late start in educational expansion compared to other countries. Other factors, such as environmental stimulation, need to be noticed in younger cohorts.

The shattered "Iron Rice Bowl": effects of Chinese state-owned enterprise reform on depressive symptoms in later life.

OBJECTIVES: The SOE reform was the first time that economic insecurity was introduced since 1949 in China, with hundreds of million employees affected by the laid off. This study took the State-Owned Enterprises (SOE) reform in China as a natural experiment to explore the impact of economic insecurity on depressive symptoms in later life. METHODS: Data were obtained from the China Health and Retirement Longitudinal Survey (CHARLS), 2014 and 2015. CHARLS is a nationally representative survey covering 28 provinces in China. CHARLS used the probabilities proportional to size (PPS) sampling method and involved 450 villages/resident committees, 150 counties/districts and 12,400 households. A total of 5113 urban dwellers born earlier than 1971 (aged 25 years old and above at the start of the SOE reform, 1995) were involved. Using the province-level  economic loss from the layoffs, we examined the impact of economic insecurity exposure on the score of depressive symptoms using a difference-in-differences model (DID). RESULTS: Individuals with economic insecurity exposure had a significantly increased risk of higher depressive symptoms scores, in which a 1 percentage point increase in expected economic loss would increase the CESD-10 score by 0.10. For an individual at the median distribution (CESD-10 = 5), this implies a shift to the 58th percentile (CESD-10 = 6). Given that the average intensity of expected economic loss is 10.22% and the mean CESD-10 is 6.92, exposure to the SOE reform led to an average increase in the CESD-10 score by 1.02 and by at least 14.74%. The heterogeneity analyses showed that the role of SOE reform in depressive symptoms scores was robust in both female and male groups and groups with different educational attainment. CONCLUSIONS: Economic insecurity exposure increased the depressive symptoms score later in life in the context of China. Programs, such as adequate unemployment insurance benefits, can protect individuals against the risk of financial loss, thereby reducing their negative impact on depressive symptoms. Providing mental symptoms surveillance and psychological counseling to those experienced at a time of great uncertainty is important for preventing depression in times of economic insecurity.

Long-term exposure to PM2.5 and O3 with cardiometabolic multimorbidity: Evidence among Chinese elderly population from 462 cities.

Cardiometabolic multimorbidity (CMM) refers to the presence of multiple cardiovascular and metabolic diseases (CMDs), such as hypertension, diabetes, and cardio-cerebrovascular diseases (CCVD), in the same individual, and has emerge as a significant global health concern due to population aging. Although previous research has demonstrated the association between cardiovascular and metabolic diseases and air pollutants, evidence on the link between CMM and air pollution exposure among Chinese older adults is limited. To address this research gap, we conducted a national representative survey of 222,179 adults aged 60 and older to investigate the epidemiology of CMM and its association with long-term exposure to PM2.5 and O3 in China's elderly population. We found that the prevalence of CMM among Chinese older adults was 16.9%, and hypertension and CCVD were the most common CMM cluster (10.8%). After adjusting for confounding variables, we observed a significant positive association between PM2.5 exposure and the prevalence of hypertension, diabetes, and CCVD, with a respective excess risk increase of 3.2%, 3.6%, and 5.5% for every 10-unit increase. Moreover, every 10-unit increase in PM2.5 was linked to a higher risk of hypertension and diabetes (2.2%), hypertension and CCVD (5.4%), diabetes and CCVD (5.6%), and hypertension, diabetes, and CCVD combined (7.6%). We also found a U-shaped curve relationship between O3 exposure and the occurrence of hypertension, diabetes, and CCVD, as well as different subtypes of CMM, with the lowest risk of O3 exposure was observed near 75-80 µg/m3. Furthermore, we identified that female and rural residents are more vulnerable to the health risks of air pollution than male and urban residents. Given the increasing aging of the population and rising prevalence of multimorbidity, policymakers should focus more attention on the female and rural elderly population to prevent and control CMM. This study provides compelling evidence that reducing air pollution levels can be an effective strategy to prevent and manage CMM among older adults.

A National Study of Homelessness, Social Determinants of Health, and Treatment Engagement Among Outpatient Medication for Opioid Use Disorder-Seeking Individuals in the United States.

BACKGROUND: Homelessness is an important social determinant of health (SDOH), impacting health outcomes for many medical conditions. Although homelessness is common among people with opioid use disorder (OUD), few studies systematically evaluate homelessness and other SDOH among people enrolled in standard of care treatment for OUD, medication for opioid use disorder (MOUD), or examine whether homelessness affects treatment engagement. METHODS: Using data from the 2016 to 2018 U.S. Treatment Episode Dataset Discharges (TEDS-D), patient demographic, social, and clinical characteristics were compared between episodes of outpatient MOUD where homelessness was reported at treatment enrollment versus independent housing using pairwise tests adjusted for multiple testing. A logistic regression model examined the relationship between homelessness and treatment length and treatment completion while accounting for covariates. RESULTS: There were 188 238 eligible treatment episodes. Homelessness was reported in 17 158 episodes (8.7%). In pairwise analysis, episodes involving homelessness were significantly different from those involving independent living on most demographic, social, and clinical characteristics, with significantly greater social vulnerability in most SDOH variables (P's < .05). Homelessness was significantly and negatively associated with treatment completion (coefficient = -0.0853, P < 0.001, 95% CI = [-0.114, -0.056], OR = 0.918) and remaining in treatment for greater than 180 days (coefficient = -0.3435, P < 0.001, 95% CI = [-0.371, -0.316], OR = 0.709) after accounting for covariates. CONCLUSIONS: Patients reporting homelessness at treatment entry in outpatient MOUD in the U.S. represent a clinically distinct and socially vulnerable population from those not reporting homelessness. Homelessness independently predicts poorer engagement in MOUD confirming that homelessness may be an independent predictor for MOUD treatment discontinuation nationally.

Enhanced denitrification of the AO-MBBR system used for expressway service area sewage treatment: A new perspective on decentralized wastewater treatment.

Decentralized wastewater treatment warrants considerable development in numerous countries and regions. Owing to the unique characteristics of high ammonia nitrogen concentrations and low carbon/nitrogen ratio, nitrogen removal is a key challenge in treating expressway service area sewage. In this study, an anoxic/oxic-moving bed biofilm reactor (A/O-MBBR) and a traditional A/O bioreactor were continuously operated for 115 days and their outcomes were compared to investigate the enhancement effect of carriers on the total nitrogen removal (TN) for expressway service area sewage. Results revealed that A/O-MBBR required lower dissolved oxygen, exhibited higher tolerance toward harsh conditions, and demonstrated better shock load resistance than traditional A/O bioreactor. The TN removal load of A/O-MBBR reached 181.5 g‧N/(m3‧d), which was 15.24% higher than that of the A/O bioreactor. Furthermore, under load shock resistance, the TN removal load of A/O-MBBR still reached 327.0 g‧N/(m3‧d), with a TN removal efficiency of above 80%. Moreover, kinetics demonstrated that the denitrification rate of the A/O-MBBR was 121.9% higher than that of the A/O bioreactor, with the anoxic tank biofilm contributing 60.9% of the total denitrification rate. Community analysis results revealed that the genera OLB8, uncultured_f_Saprospiraceae and OLB12 were the dominant in biofilm loaded on carriers, and OLB8 was the key for enhanced denitrification. FAPROTAX and PICRUSt2 analyses confirmed that more bacteria associated with nitrogen metabolism were enriched by the A/O-MBBR carriers through full denitrification metabolic pathway and dissimilatory nitrate reduction pathway. This study offers a perspective into the development of cost-effective and high-efficiency treatment solutions for expressway service area sewage.

[Quality evaluation of Commelina communis from different origins based on multicomponent content determination combined with chemometrics].

This research established a high-performance liquid chromatography(HPLC) method for simultaneous determination of isoorientin, orientin, vitexin, and isovitexin in Commelina communis to conduct content difference analysis and quality evaluation of 62 batches of C. communis from different origins. The HPLC content determination was performed on a Dikma Platisil ODS chromatographic column(4.6 mm×250 mm, 5 µm), with acetonitrile-0.1% formic acid(14∶86) as the mobile phase. The detection wavelength was set at 348 nm, the flow rate was 1.0 mL·min~(-1), and the column temperature was 35 ℃. The differences in origins and quality of 62 batches of C. communis were studied by chemometrics. The results showed that the determination of four components mani-fested a good linear relationship in the range of mass concentration(r>0.999 9), and the average recovery rate was 96.17%-103.0%. The relative standard deviations(RSDs) of precision, stability, and repeatability were all less than 2.0%. The content of four components from high to low was isoorientin>isovitexin>orientin>vitexin. Forty-seven batches of C. communis with clear origins were classified into six categories by chemometrics. C. communis from different origins had different qualities. Generally, C. communis from Western China, Central China, and South of China had superior qualities. The HPLC method established in this study is specific, simple, and efficient, which provides references for the comprehensive evaluation of the quality of C. communis. The chemometrics shows that the qualities of C. communis from different origins are largely different. Isoorientin can be used as an index to determine the content of C. communis, and its content limit should be set no less than 0.023%.

In vitro maturation without gonadotropins versus in vitro fertilization with hyperstimulation in women with polycystic ovary syndrome: a non-inferiority randomized controlled trial.

STUDY QUESTION: Does in vitro maturation (IVM) result in non-inferior cumulative live birth rates compared to those after standard in vitro fertilization (IVF) in infertile women with polycystic ovary syndrome (PCOS)? SUMMARY ANSWER: One cycle of IVM, without any stimulation, was inferior to one cycle of standard IVF in women with PCOS in terms of 6-month cumulative live birth rates, when choosing single vitrified-warmed blastocyst transfer. WHAT IS KNOWN ALREADY: IVM is an emerging alternative treatment for women with PCOS who need assisted reproductive technology. Since a minimal or even zero dose of gonadotropins are required in the IVM procedure, the occurrence of ovarian hyperstimulation syndrome (OHSS) is eliminated. Only one clinical trial comparing the pregnancy outcome between IVM with FSH priming and IVF has been reported. However, it is still unknown whether IVM treatment without any stimulation can offer a similar live birth outcome in women with PCOS as compared to that in women receiving the standard IVF procedure with ovarian stimulation. STUDY DESIGN, SIZE, DURATION: This single-centre, open-label randomized controlled non-inferiority trial in an academic infertility centre in China was performed between March 2018 and July 2019. PARTICIPANTS/MATERIALS, SETTING, METHODS: Women aged 20-38 years with PCOS and infertility scheduled for their first IVF attempt were eligible. In total, 351 women were randomly allocated to receive one cycle of unstimulated IVM (n = 175) or one cycle of standard IVF with a flexible GnRH antagonist protocol and hCG as ovulatory trigger (n = 176). A freeze-all and single blastocyst transfer strategy was used in both groups. The primary outcome was ongoing pregnancy (leading to live birth) within 6 months after randomization. A non-inferiority margin of 15% was considered. MAIN RESULTS AND THE ROLE OF CHANCE: The IVM procedure without additional gonadotropin resulted in a lower ongoing pregnancy (leading to live birth) within 6 months after randomization compared to standard IVF treatment (22.3% vs. 50.6%; rate difference -28.3%; 95% confidence interval [CI]: -37.9% to -18.7%). Moderate-severe OHSS did not occur in the IVM group, while in the IVF group, ten women (5.7%) had moderate OHSS and one woman (0.6%) had severe OHSS. There was no statistically significant difference in the occurrence of obstetric and perinatal complications. LIMITATIONS, REASONS FOR CAUTION: The trial was conducted using an IVM protocol without additional stimulation in a single centre, which may limit its generalizability. In addition, a GnRH agonist trigger rather than hCG for IVF stimulation in women with PCOS would be more consistent with current clinical practice. WIDER IMPLICATIONS OF THE FINDINGS: Although IVM is considered to be a convenient, inexpensive and safe alternative to IVF for women with PCOS, our results indicated that one cycle of IVM without any stimulation was inferior to one cycle of standard IVF in terms of the cumulative live birth rate. The inferiority of IVM without ovarian stimulation could be mainly due to the limitations in the developmental potential of embryos. Further IVM development should be tested and validated in a freeze-only and blastocyst transfer setting. Further RCTs are needed to evaluate the effectiveness and safety of other IVM protocols or multiple cycles of IVM compared to IVF. STUDY FUNDING/COMPETING INTEREST(S): This study was supported by the National Key Research and Development Program of China (2016YFC1000201 and 2018YFC1002104) and the National Science Foundation of China (81730038). B.W.M. is supported by a NHMRC Investigator grant (GNT1176437). All other authors declare no competing interests. TRIAL REGISTRATION NUMBER: Clinicaltrials.gov NCT03463772. TRIAL REGISTRATION DATE: 29 January 2018. DATE OF FIRST PATIENT'S ENROLMENT: 16 March 2018.

Poor morphology of inner cell mass increases birth weight and large for gestational age.

RESEARCH QUESTION: Can inner cell mass (ICM) and trophectoderm morphological grading, especially ICM and trophectoderm graded C, affect perinatal outcomes? DESIGN: A retrospective review of medical records of 8946 singletons delivered from vitrified-warmed single blastocyst transfer cycles between January 2009 and December 2020. RESULTS: Inner cell mass graded C had a higher adjusted birth weight than ICM graded A (0.61 ± 1.06 versus 0.48 ± 1.06; P = 0.025). Large for gestational age (LGA) increased with decreasing ICM morphological grading (18.96%, 21.88% and 23.38%; grade B versus grade A, P = 0.013; grade C versus grade A, P = 0.036) (P < 0.025 was considered statistically significant for multiple pairwise comparisons). Linear regression analysis suggested that ICM morphological grading was significantly associated with adjusted birth weight, with grade C increasing adjusted birth weight compared with grade A (ß 0.13, 95% CI 0.00 to 0.25, P = 0.043) (P < 0.05 was considered statistically significant for linear regression). Logistic regression analysis suggested that ICM morphological grading was significantly associated with LGA, with grade C increasing LGA compared with grade A (adjusted OR 1.37, 95% CI 1.03 to 1.81). Moreover, blastocysts with ICM graded C had a higher chance of being a male infant compared with ICM graded A (adjusted OR 1.32, 95% CI 1.04 to 1.68). CONCLUSIONS: Inner cell mass morphological grading was significantly associated with adjusted birth weight and LGA. Poor ICM graded C increased birth weight and LGA.

Synthesis of 2-Deoxyglycosides Bearing Free Hydroxyl Substituents on the Glycosyl Donor.

Recent efforts in the field of carbohydrate chemistry have focused on the site- and stereocontrolled synthesis of O-glycosides derived from acceptors bearing multiple hydroxyl substituents. By comparison, there are few examples of the site-selective synthesis of O-glycosides bearing free hydroxyl substituents on the donor reagent. Here, we report the application of an umpolung glycosylation strategy to the synthesis of O-glycosides derived from donors bearing free hydroxyl substituents. The reaction proceeds via prior deprotonation of one or more free hydroxyl groups on a thiophenylglycoside donor, reductive lithiation to generate an anomeric anion intermediate, and addition of this anion to an alkyl 2-(2-methyltetrahydropyranyl) peroxide. By this approach, α-linked glycosides were obtained in 39-84% yields and with >50:1 α/ß selectivities. In many instances, ß-linked products could be obtained by thermal equilibration of the anomeric anion intermediate (selectivities = 3.8-8:1 ß/α; yields = 33-68%). The strategy is applicable to polyhydroxyl donors bearing up to three free hydroxyl groups, N-acylated carbohydrates, and the single-flask syntheses of oligosaccharides.

Prediction and characterization of a novel hemoglobin-derived mutant peptide (mTgHbP7) from Tegillarca granosa.

The hemoglobin (Hb) is identified in Tegillarca granosa and its derived peptides have been proved to possess antibacterial activity against gram-positive and gram-negative bacteria. In this study, we identified a series of novel antimicrobial peptides (AMPs) and artificially mutated AMPs derived from subunits of T. granosa Hbs, among which, a mutant T. granosa hemoglobin peptide (mTgHbP) mTgHbP7, was proved to possess predominant antibacterial activity against three bacteria strains (Vibrio alginolyticus, V. parahaemolyticus and Escherichia coli). Besides, mTgHbP7 was predicted to form α-helical structure, which was known to be an important feature of bactericidal AMPs. Furthermore, upon contact with HEK293 cell line, we confirmed that mTgHbP7 had no cytotoxicity to mammalian cell even at a high concentration of 160 µM. Therefore, the findings reported here provide a rationalization for antimicrobial peptide prediction and optimization from mollusk hemoglobin, which will be useful for future development of antimicrobial agents.