Photo-induced difluoroalkylation/cyclization of alkyne ketones: a novel strategy to access difluoroalkyl thiofavones.

A photo-induced electron donor-acceptor (EDA) complex enabled tandem reaction of alkyne ketones via a radical difluoroalkylation/cyclization cascade sequence is reported. The EDA complex plays a key role, and the C-Br bond homolysis process may also be involved for this transformation. Varieties of difluoroalkyl-substituted thiofavones can be smoothly assembled in moderate to good yields under photocatalyst-, metal- and oxidant-free conditions, thus offering potential applications for pharmaceutical research.

meta-C-H functionalization of phenylethyl and benzylic alcohol derivatives via Pd/NBE relay catalysis.

The transition metal-catalyzed meta-C-H functionalization of alcohols and their hydroxylamine derivatives remains underdeveloped. Herein, we report an efficient meta-C-H arylation of both phenylethyl and benzylic alcohols and their hydroxylamine derivatives using a readily removable oxime ether directing group. Using electronically activated 2-carbomethoxynorbornene as the transient mediator and 3-trifluoromethyl-2-pyridone as the enabling ligand, this reaction features a broad substrate scope and good functional group tolerance. More importantly, with this oxime-directed meta-C-H functionalization, this method provides a dual approach for efficient access to both meta-substituted alcohols and hydroxylamines using two sets of simple deprotection conditions. This protocol leads to the efficient synthesis of bioactive compounds possessing promising reactivities for the treatment of pulmonary fibrosis.

Transcranial direct current stimulation enhances the protective effect of isoflurane preconditioning on cerebral ischemia/reperfusion injury: A new mechanism associated with the nuclear protein Akirin2.

AIMS: Ischemic stroke is a major cause of disability and mortality worldwide. Transcranial direct current stimulation (tDCS) and isoflurane (ISO) preconditioning exhibit neuroprotective properties. However, it remains unclear whether tDCS enhances the protective effect of ISO preconditioning on ischemic stroke, and the underlying mechanisms are yet to be clarified. METHOD: A model of middle cerebral artery occlusion (MCAO), a rat ischemia-reperfusion (I/R) injury model, and an in vitro oxygen-glucose deprivation/re-oxygenation (O/R) model of ischemic injury were developed. ISO preconditioning and tDCS were administered daily for 7 days before MCAO modeling. Triphenyltetrazolium chloride staining, modified neurological severity score, and hanging-wire test were conducted to assess infarct volume and neurological outcomes. Untargeted metabolomic experiments, adeno-associated virus, lentiviral vectors, and small interfering RNA techniques were used to explore the underlying mechanisms. RESULTS: tDCS/DCS enhanced the protective effects of ISO pretreatment on I/R injury-induced brain damage. This was evidenced by reduced infarct volume and improved neurological outcomes in rats with MCAO, as well as decreased cortical neuronal death after O/R injury. Untargeted metabolomic experiments identified oxidative phosphorylation (OXPHOS) as a critical pathological process for ISO-mediated neuroprotection from I/R injury. The combination of tDCS/DCS with ISO preconditioning significantly inhibited I/R injury-induced OXPHOS. Mechanistically, Akirin2, a small nuclear protein that regulates cell proliferation and differentiation, was found to decrease in the cortex of rats with MCAO and in cortical primary neurons subjected to O/R injury. Akirin2 functions upstream of phosphatase and tensin homolog deleted on chromosome 10 (PTEN). tDCS/DCS was able to further upregulate Akirin2 levels and activate the Akirin2/PTEN signaling pathway in vivo and in vitro, compared with ISO pretreatment alone, thereby contributing to the improvement of cerebral I/R injury. CONCLUSION: tDCS treatment enhances the neuroprotective effects of ISO preconditioning on ischemic stroke by inhibiting oxidative stress and activating Akirin2-PTEN signaling pathway, highlighting potential of combination therapy in ischemic stroke.

Combined use of CLP290 and bumetanide alleviates neuropathic pain and its mechanism after spinal cord injury in rats.

AIM: We aimed to explore whether the combination of CLP290 and bumetanide maximally improves neuropathic pain following spinal cord injury (SCI) and its possible molecular mechanism. METHODS: Rats were randomly divided into five groups: Sham, SCI + vehicle, SCI + CLP290, SCI + bumetanide, and SCI + combination (CLP290 + bumetanide). Drug administration commenced on the 7th day post-injury (7 dpi) and continued for 14 days. All rats underwent behavioral assessments for 56 days to comprehensively evaluate the effects of interventions on mechanical pain, thermal pain, cold pain, motor function, and other relevant parameters. Electrophysiological assessments, immunoblotting, and immunofluorescence detection were performed at different timepoints post-injury, with a specific focus on the expression and changes of KCC2 and NKCC1 proteins in the lumbar enlargement of the spinal cord. RESULTS: CLP290 and bumetanide alleviated SCI-associated hypersensitivity and locomotor function, with the combination providing enhanced recovery. The combined treatment group exhibited the most significant improvement in restoring Rate-Dependent Depression (RDD) levels. In the combined treatment group and the two individual drug administration groups, the upregulation of potassium chloride cotransporter 2 (K+-Cl-cotransporter 2, KCC2) expression and downregulation of sodium potassium chloride cotransporter 1 (Na+-K+-Cl-cotransporter 1, NKCC1) expression in the lumbar enlargement area resulted in a significant increase in the KCC2/NKCC1 ratio compared to the SCI + vehicle group, with the most pronounced improvement seen in the combined treatment group. Compared to the SCI + vehicle group, the SCI + bumetanide group showed no significant paw withdrawal thermal latency (PWTL) improvement at 21 and 35 dpi, but a notable enhancement at 56 dpi. In contrast, the SCI + CLP290 group significantly improved PWTL at 21 days, with non-significant changes at 35 and 56 days. At 21 dpi, KCC2 expression was marginally higher in monotherapy groups versus SCI + vehicle, but not significantly. At 56 dpi, only the SCI + bumetanide group showed a significant difference in KCC2 expression compared to the control group. CONCLUSION: Combined application of CLP290 and bumetanide effectively increases the ratio of KCC2/NKCC1, restores RDD levels, enhances GABAA receptor-mediated inhibitory function in the spinal cord, and relieves neuropathic pain in SCI; Bumetanide significantly improves neuropathic pain in the long term, whereas CLP290 demonstrates a notable short-term effect.

An enhanced AlexNet-Based model for femoral bone tumor classification and diagnosis using magnetic resonance imaging.

Objective: Bone tumors, known for their infrequent occurrence and diverse imaging characteristics, require precise differentiation into benign and malignant categories. Existing diagnostic approaches heavily depend on the laborious and variable manual delineation of tumor regions. Deep learning methods, particularly convolutional neural networks (CNNs), have emerged as a promising solution to tackle these issues. This paper introduces an enhanced deep-learning model based on AlexNet to classify femoral bone tumors accurately. Methods: This study involved 500 femoral tumor patients from July 2020 to January 2023, with 500 imaging cases (335 benign and 165 malignant). A CNN was employed for automated classification. The model framework encompassed training and testing stages, with 8 layers (5 Conv and 3 FC) and ReLU activation. Essential architectural modifications included Batch Normalization (BN) after the first and second convolutional filters. Comparative experiments with various existing methods were conducted to assess algorithm performance in tumor staging. Evaluation metrics encompassed accuracy, precision, sensitivity, specificity, F-measure, ROC curves, and AUC values. Results: The analysis of precision, sensitivity, specificity, and F1 score from the results demonstrates that the method introduced in this paper offers several advantages, including a low feature dimension and robust generalization (with an accuracy of 98.34 %, sensitivity of 97.26 %, specificity of 95.74 %, and an F1 score of 96.37). These findings underscore its exceptional overall detection capabilities. Notably, when comparing various algorithms, they generally exhibit similar classification performance. However, the algorithm presented in this paper stands out with a higher AUC value (AUC=0.848), signifying enhanced sensitivity and more robust specificity. Conclusion: This study presents an optimized AlexNet model for classifying femoral bone tumor images based on convolutional neural networks. This algorithm demonstrates higher accuracy, precision, sensitivity, specificity, and F1-score than other methods. Furthermore, the AUC value further confirms the outstanding performance of this algorithm in terms of sensitivity and specificity. This research makes a significant contribution to the field of medical image classification, offering an efficient automated classification solution, and holds the potential to advance the application of artificial intelligence in bone tumor classification.

Coordination Between Respiration and Swallowing in Patients With Dysphagia After Cervical Spinal Cord Injury: An Observational Case-Control Study.

PURPOSE: The purpose of the present study was to characterize the differences between respiration and swallowing in patients with dysphagia after cervical spinal cord injury (CSCI) and to explore the underlying physiological changes. METHOD: A total of 95 participants were recruited for bedside swallowing evaluation followed by a flexible endoscopic evaluation of swallowing and surface electromyography with a thermocouple nasal airflow sensor examination: 32 with dysphagia, 33 without dysphagia, and 30 healthy controls. The differences in respiratory patterns, swallowing apnea duration (SAD), inspiratory-expiratory ratio, and swallowing efficiency were observed among healthy adults, CSCI patients with and without dysphagia after CSCI. RESULTS: Compared with those of healthy controls and patients without dysphagia after CSCI, the postswallow respiratory pattern of patients with dysphagia after CSCI was an inspiratory pattern, and the SAD was significantly shorter in patients with dysphagia after CSCI (p < .001). Additionally, the expiratory time in patients with dysphagia was significantly shorter than the inspiratory time, and the swallowing efficiency was reduced, requiring multiple swallows. Moreover, the index of SAD was statistically significant for predicting the development of dysphagia in patients with CSCI (p < .001). CONCLUSION: Patients with CSCI have an inspiratory pattern after swallowing, and the SAD is significantly reduced; SAD can be used as the predictor of dysphagia in patients after CSCI; the pattern of coordination between respiration and swallowing in patients with dysphagia after CSCI is different from that of healthy controls and patients without dysphagia after CSCI. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.26524717.

Cancer-associated fibroblasts derived fibronectin extra domain A promotes sorafenib resistance in hepatocellular carcinoma cells by activating SHMT1.

Resistance to sorafenib, an effective first-line treatment for advanced hepatocellular carcinoma (HCC), greatly compromised the prognosis of patients. The extracellular matrix is one of the most abundant components of the tumor microenvironment. Beyond acting as a physical barrier, it remains unclear whether cell interactions and signal transduction mediated by the extracellular matrix contribute to sorafenib resistance. With the analysis of primary HCC organoid RNA-seq data combined with in vivo and in vitro experiments validation, we discovered that fibronectin extra domain A (FN-EDA) derived from cancer-associated fibroblasts played a critical role in sorafenib resistance. Mechanistically, FN-EDA stimulates the up-regulation of the key one-carbon metabolism enzyme SHMT1 in HCC cells via the TLR4/NF-κB signaling pathway, thereby countering the oxidative stress induced by sorafenib. Moreover, we reinforced the clinical significance of our discoveries by conducting in vivo assays with an immunodeficiency subcutaneous xenograft tumor model, which was established using primary cancer-associated fibroblasts derived from clinical HCC tissues, and through the analysis of HCC samples obtained from The Cancer Genome Atlas (TCGA) database. Our findings suggest that targeting the FN-EDA/SHMT1 pathway could be a potential strategy to improve sorafenib responsiveness in HCC patients.

Controlling the growth mode of Au depositing on Au nanobipyramids via ligand coverage for SERS enhancement.

Gold deposition on Au nanoparticles is a common method to control the shape and further modify the properties of nanoparticles as their properties have a strong correlation with their nanostructures. For Au nanobipyramid (Au NBP), it has advantages such as the enhancement of electric field and a higher tunability in plasmon wavelength than the Au nanorod and thus owns a greater potential in shape control. In this paper, we demonstrate a scheme of depositing Au on the surface of Au NBP with the presence of a type of ligand 2-mercaptobenzoimidazole-5-carboxylic acid (MBIA) to synthesize Au NBP@Au dimers. The growth mode of Au depositing on Au NBP can be controlled by the coverage of MBIA. As the coverage is low, with a concentration of MBIA below 0.4 mM, the rough core-shell nanostructure is synthesized; However, as the coverage is high, with a concentration of MBIA over 0.8 mM, gold deposition may form islands on the surface of Au NBP. The SERS performance of Au depositing on Au NBP can also be enhanced by growth mode. For the rough-surface core-shell growth mode, the enhancement is more significant as the EF is improved from 3.5 × 105 to 1.06 × 106 than the islands-growing growth mode due to the coupling between core and shell. And our results show that with multiple types of nanosturctures easy to obtained by changing modified ligand coverage, the controlled growth has a great potential in the dimer design and SERS enhancement using Au NBP.

Radiographic imaging and diagnosis of spinal bone tumors: AlexNet and ResNet for the classification of tumor malignancy.

Objective: This study aims to explore the application of radiographic imaging and image recognition algorithms, particularly AlexNet and ResNet, in classifying malignancies for spinal bone tumors. Methods: We selected a cohort of 580 patients diagnosed with primary spinal osseous tumors who underwent treatment at our hospital between January 2016 and December 2023, whereby 1532 images (679 images of benign tumors, 853 images of malignant tumors) were extracted from this imaging dataset. Training and validation follow a ratio of 2:1. All patients underwent X-ray examinations as part of their diagnostic workup. This study employed convolutional neural networks (CNNs) to categorize spinal bone tumor images according to their malignancy. AlexNet and ResNet models were employed for this classification task. These models were fine-tuned through training, which involved the utilization of a database of bone tumor images representing different categories. Results: Through rigorous experimentation, the performance of AlexNet and ResNet in classifying spinal bone tumor malignancy was extensively evaluated. The models were subjected to an extensive dataset of bone tumor images, and the following results were observed. AlexNet: This model exhibited commendable efficiency during training, with each epoch taking an average of 3 s. Its classification accuracy was found to be approximately 95.6 %. ResNet: The ResNet model showed remarkable accuracy in image classification. After an extended training period, it achieved a striking 96.2 % accuracy rate, signifying its proficiency in distinguishing the malignancy of spinal bone tumors. However, these results illustrate the clear advantage of AlexNet in terms of proficiency despite a lower classification accuracy. The robust performance of the ResNet model is auspicious when accuracy is more favored in the context of diagnosing spinal bone tumor malignancy, albeit at the cost of longer training times, with each epoch taking an average of 32 s. Conclusion: Integrating deep learning and CNN-based image recognition technology offers a promising solution for qualitatively classifying bone tumors. This research underscores the potential of these models in enhancing the diagnosis and treatment processes for patients, benefiting both patients and medical professionals alike. The study highlights the significance of selecting appropriate models, such as ResNet, to improve accuracy in image recognition tasks.

A compact motorized end-effector for ankle rehabilitation training.

This paper introduces a compact end-effector ankle rehabilitation robot (CEARR) system for addressing ankle range of motion (ROM) rehabilitation. The CEARR features a bilaterally symmetrical rehabilitation structure, with each side possessing three degrees of freedom (DOF) driven by three independently designed actuators. The working intervals of each actuator are separated by a series connection, ensuring they operate without interference to accommodate the dorsiflexion/plantarflexion (DO/PL), inversion/eversion (IN/EV), and adduction/abduction (AD/AB) DOF requirements for comprehensive ankle rehabilitation. In addition, we integrated an actuator and foldable brackets to accommodate patients in varied postures. We decoded the motor intention based on the surface electromyography (sEMG) and torque signals generated by the subjects' ankle joints in voluntary rehabilitation. Besides, we designed a real-time voluntary-triggered control (VTC) strategy to enhance the rehabilitation effect, in which the root mean square (RMS) of sEMG was utilized to trigger and adjust the CEARR rehabilitation velocity support. We verified the consistency of voluntary movement with CEARR rehabilitation support output for four healthy subjects on a nonlinear sEMG signal with an R 2 metric of approximately 0.67. We tested the consistency of triggering velocity trends with a linear torque signal for one healthy individual with an R 2 metric of approximately 0.99.

Protocol for measuring the effects of an inhibitory signal associated with danger on honey bee dopamine levels.

The stop signal is produced in response to negative experiences at the food source and inhibits honey bee (Apis mellifera) waggle dancing. Here, we present a protocol for measuring the effects of an inhibitory signal associated with danger on honey bee dopamine levels. We describe steps for observing honey bee colonies, training them with artificial nectar, and simulating hornet attacks. We then detail procedures for recording waggle dancing and stop signals and measuring brain dopamine levels during different treatments. For complete details on the use and execution of this protocol, please refer to Dong et al.1.

Neuronal repair after spinal cord injury by in vivo astrocyte reprogramming mediated by the overexpression of NeuroD1 and Neurogenin-2.

BACKGROUND: As a common disabling disease, irreversible neuronal death due to spinal cord injury (SCI) is the root cause of functional impairment; however, the capacity for neuronal regeneration in the developing spinal cord tissue is limited. Therefore, there is an urgent need to investigate how defective neurons can be replenished and functionally integrated by neural regeneration; the reprogramming of intrinsic cells into functional neurons may represent an ideal solution. METHODS: A mouse model of transection SCI was prepared by forceps clamping, and an adeno-associated virus (AAV) carrying the transcription factors NeuroD1 and Neurogenin-2(Ngn2) was injected in situ into the spinal cord to specifically overexpress these transcription factors in astrocytes close to the injury site. 5-bromo-2´-deoxyuridine (BrdU) was subsequently injected intraperitoneally to continuously track cell regeneration, neuroblasts and immature neurons marker expression, neuronal regeneration, and glial scar regeneration. In addition, immunoprotein blotting was used to measure the levels of transforming growth factor-ß (TGF-ß) pathway-related protein expression. We also evaluated motor function, sensory function, and the integrity of the blood-spinal cord barrier(BSCB). RESULTS: The in situ overexpression of NeuroD1 and Ngn2 in the spinal cord was achieved by specific AAV vectors. This intervention led to a significant increase in cell regeneration and the proportion of cells with neuroblasts and immature neurons cell properties at the injury site(p < 0.0001). Immunofluorescence staining identified astrocytes with neuroblasts and immature neurons cell properties at the site of injury while neuronal marker-specific staining revealed an increased number of mature astrocytes at the injury site. Behavioral assessments showed that the intervention did not improve The BMS (Basso mouse scale) score (p = 0.0726) and gait (p > 0.05), although the treated mice had more sensory sensitivity and greater voluntary motor ability in open field than the non-intervention mice. We observed significant repair of the BSCB at the center of the injury site (p < 0.0001) and a significant improvement in glial scar proliferation. Electrophysiological assessments revealed a significant improvement in spinal nerve conduction (p < 0.0001) while immunostaining revealed that the levels of TGF-ß protein at the site of injury in the intervention group were lower than control group (p = 0.0034); in addition, P70 s6 and PP2A related to the TGF-ß pathway showed ascending trend (p = 0.0036, p = 0.0152 respectively). CONCLUSIONS: The in situ overexpression of NeuroD1 and Ngn2 in the spinal cord after spinal cord injury can reprogram astrocytes into neurons and significantly enhance cell regeneration at the injury site. The reprogramming of astrocytes can lead to tissue repair, thus improving the reduced threshold and increasing voluntary movements. This strategy can also improve the integrity of the blood-spinal cord barrier and enhance nerve conduction function. However, the simple reprogramming of astrocytes cannot lead to significant improvements in the striding function of the lower limbs.

Development and Application of SPOSiPs: A Class of Diphosphine Ligands Based on SPOSiOL.

Here, we report the development and application of a novel class of spirosilacycle-based diphosphine ligands (SPOSiPs). This type of diphosphine ligand could be readily prepared in two steps with high efficiency starting from enantiopure spirobiphenoxasilin-diol (SPOSiOL). According to the structural analysis of SPOSiP and its PdCl2 complex, SPOSiPs possess a flexible chiral pocket and feature a rigid configuration, a large dihedral angle, a long P-P distance, and a large P-M-P bite angle in their metal complexes. The potentials of SPOSiPs in asymmetric catalysis have also been preliminarily disclosed.

Controlled Spread of a Ag Layer from the Core to the Tip along the Branches of AuAg Nanostars for Improved SERS Detection of Okadaic Acid in Shellfish.

Plasmonic Au-Ag nanostars are excellent surface-enhanced Raman scattering (SERS) probes due to bimetallic coupling and the tip effect. However, the existing preparation methods of AuAg nanostars cannot achieve controlled growth of the Ag layer on the branches of nanostars and so cannot display their SERS to the maximum extent, thus limiting its sensitivity in biosensing. Herein, a novel strategy "PEI (polyethylenimine)-guided Ag deposition method" is proposed for synthesizing AuAg core-shell nanostars (AuAg@Ag NS) with a tunable distribution of the Ag layer from the core to the tip, which offers an avenue for investigating the correlation between SERS efficiency and the extent of spread of the Ag layer. It is found that AuAg@Ag NS with a Ag layer coated the whole branch has the strongest SERS performance because the coupling between the tips and Ag layer is maximized. Meanwhile, as a completely closed core-shell structure, AuAg@Ag NS can confine and anchor 4-ATP inside the Ag layer to avoid an unstable SERS signal. By connecting the aptamer, a reliable internal standard nanoprobe with a SERS enhancement factor (EF) up to 1.86 × 108 is prepared. Okada acid is detected through competitive adsorption of this SERS probes, and the detection limit is 36.6 pM. The results gain fundamental insights into tailoring the nanoparticle morphologies and preparation of internal standard nanoprobes and also provide a promising avenue for marine toxin detection in food safety.

Case report: POEMS syndrome with portal hypertension.

This patient was an elderly patient with abdominal distension and shortness of breath. According to relevant examinations, his condition was initially considered to be related to cirrhosis, but pathological biopsy confirmed the diagnosis of noncirrhotic portal hypertension of unknown etiology. The portal vein pressure was significantly reduced after transjugular intrahepatic portosystemic shunt (TIPS). Nevertheless, the relief of the hydrothorax and ascites was not significant, and the numbness in both lower limbs gradually worsened. POEMS syndrome was ultimately diagnosed following a comprehensive examination. After two courses of bortezomib combined with dexamethasone, the patient died due to a systemic infection. The clinical symptoms of the patient were atypical, as was the presence of portal hypertension, which hindered the diagnosis of POEMS. Due to the patient's advanced age, the diagnosis was delayed, and the prognosis was poor. This case reminds clinicians that POEMS patients can also have portal hypertension as the main manifestation.

Interpretation of Chinese Expert Consensus on the Diagnosis and Management Strategy of Patients with Statin Intolerance: A guiding file for helping to lipid management for Chinese population.

It is well-known that elevated low-density lipoprotein cholesterol (LDL-C) is a causal risk factor for atherosclerotic cardiovascular disease (ASCVD), statins are cornerstone drugs for the cause-based treatment of ASCVD, which has created a new era for ASCVD therapy. However, statin intolerance is not clinically uncommon, which there are several issues with confusion and misunderstandings. Hence, a file named Chinese Expert Consensus on the Diagnosis and Management Strategy of Patients With Statin Intolerance, like a navigator, has recently been published written by a team of experts from the Cardiovascular Metabolic Medicine Professional Committee, Expert Committee of the National Center for Cardiovascular Diseases aiming to enhance the standardized clinical application of statins and improve the prevention and clinical outcome. In this article, author briefly summarized the key points of above consensus in order to helping to comprehending the content of the consensus suggestions.

Impact of formaldehyde on ozone formation in Central China: Important role of biogenic emission in forest region.

Formaldehyde (HCHO) is an important source for driving tropospheric ozone (O3) formation. This study investigated the combined effects of anthropogenic and biogenic emission on O3 formation in the Guanzhong Basin (GZB), Central China, providing useful information into the mechanisms of O3 formation due to the interaction between anthropogenic and biogenic volatile organic compounds (VOCs). A severe O3 pollution episode in summer of 2017 was simulated using the Weather Research and Forecasting model coupled with Chemistry (WRF-Chem) to examine the impacts of ambient HCHO on ground-level O3. Results showed secondary HCHO dominated ambient levels, peaking in the afternoon (up to 86 %), while primary emissions contributed 14 % on average. This enhanced O3 production by 7.7 % during the morning rush hour and 24.3 % in the afternoon. In addition, HCHO concentration peaked before that of O3, suggesting it plays significant role in O3 formation. Biogenic emission oxidation contributed 3.1 µg m-3 (53.1 %) of HCHO and 5.2 pptv (40.1 %) of hydroperoxyl radicals (HO2) in average urban areas, where the downwind regions of the forests had high nitrogen oxides (NOx) levels and favorable conditions for O3 production (17.3 µg m-3, 20.5 %). In forested regions, sustained isoprene oxidation led to elevated oxidized VOCs including HCHO and acetaldehyde downwind, which practiced further photolysis of O3 formation with anthropogenic NOx in urban areas. Sensitivity experiments recommend controlling industrial and traffic NOx emissions, with regional joint prevention and regulation, which are essential to reduce O3 pollution.

Trends and Patterns of HIV Transmitted Drug Resistance in China From 2018 to 2023.

BACKGROUND: National treatment guidelines of China evolving necessitates population-level surveillance of transmitted drug resistance (TDR) to inform or update HIV treatment strategies. METHODS: We analyzed the demographic, clinical, and virologic data obtained from people with HIV (PWH) residing in 31 provinces of China who were newly diagnosed between 2018 and 2023. Evidence of TDR was defined by the World Health Organization list for surveillance of drug resistance mutations. RESULTS: Among the 22 124 PWH with protease and reverse transcriptase sequences, 965 (4.36%; 95% CI, 4.1-4.63) had at least 1 TDR mutation. The most frequent TDR mutations were nonnucleoside reverse transcriptase inhibitor (NNRTI) mutations (2.39%; 95% CI, 2.19%-2.59%), followed by nucleoside reverse transcriptase inhibitor mutations(1.35%; 95% CI, 1.2%-1.5%) and protease inhibitor mutations (1.12%; 95% CI, .98%-1.26%). The overall protease and reverse transcriptase TDR increased significantly from 4.05% (95% CI, 3.61%-4.52%) in 2018 to 5.39% (95% CI, 4.33%-6.57%) in 2023. A low level of integrase strand transfer inhibitor TDR was detected in 9 (0.21%; 95% CI, .1%-.38%) of 4205 PWH. CONCLUSIONS: Presently, the continued use of NNRTI-based first-line antiretroviral therapy regimen for HIV treatment has been justified.

Prognostic Value of Plasma Endothelin-1 in Predicting Worse Outcomes in Patients with Prediabetes and Diabetes and Stable Coronary Artery Diseases.

Background: Endothelin-1 (ET-1) is an endogenous vasoconstrictor implicated in coronary artery disease (CAD) and diabetes. This study aimed to determine the prognostic value of ET-1 in the patients with stable CAD under different glucose metabolism states. Methods: In this prospective, large-cohort study, we consecutively enrolled 7,947 participants with angiography-diagnosed stable CAD from April 2011 to April 2017. Patients were categorized by baseline glycemic status into three groups (normoglycemia, prediabetes, and diabetes) and further divided into nine groups by circulating ET-1 levels. Patients were followed for the occurrence of cardiovascular events (CVEs), including nonfatal myocardial infarction, stroke, and cardiovascular mortality. Results: Of the 7,947 subjects, 3,352, 1,653, and 2,942 had normoglycemia, prediabetes, and diabetes, respectively. Over a median follow-up of 37.5 months, 381 (5.1%) CVEs occurred. The risk for CVEs was significantly higher in patients with elevated ET-1 levels after adjustment for potential confounders. When patients were categorized by both status of glucose metabolism and plasma ET-1 levels, the high ET-1 levels were associated with higher risk of CVEs in prediabetes (adjusted hazard ratio [HR], 2.089; 95% confidence interval [CI], 1.151 to 3.793) and diabetes (adjusted HR, 2.729; 95% CI, 1.623 to 4.588; both P<0.05). Conclusion: The present study indicated that baseline plasma ET-1 levels were associated with the prognosis in prediabetic and diabetic patients with stable CAD, suggesting that ET-1 may be a valuable predictor in CAD patients with impaired glucose metabolism.

Toxicity Evaluation and Transcriptome Analysis of Yellowstripe Goby (Mugilogobius chulae) in Response to 2,7-Dibromocarbazole Exposure during Early Development.

Polyhalogenated carbazoles (PHCZs) are a class of nitrogen-containing heterocyclic compounds that are widely distributed throughout the marine environment and sediment. These compounds share structural and toxicity similarities with dioxins. However, our understanding of the toxicological effects of PHCZs on marine organisms and their underlying molecular mechanisms remains limited. In this study, we employed the marine model organism Mugilogobius chulae as the experimental subject and selected 2,7-dibromocarbazole (2,7-DBCZ), a compound known for its high toxicity and detection frequency, to conduct both an acute toxicity test and transcriptome analysis on M. chulae embryos. Our findings revealed that the 96 h median lethal concentration (LC50) of 2,7-DBCZ for M. chulae embryos was 174 µg/L, with a median effective concentration (EC50) resulting in pericardial edema deformity of 88.82 µg/L. Transcriptome analysis revealed significant impacts on various systems in M. chulae embryos following exposure to 2,7-DBCZ, including the sensory, cardiovascular, immune, and endocrine systems. Furthermore, this compound perturbed signaling pathways such as phototransduction, protein folding and processing, amino acid metabolism, lipid transport, and exogenous compound metabolism. Notably, transcript abundance of the CYP1A gene associated with the activation of the AhR signaling pathway, similar to dioxin-like compounds, was 18.18 times higher than that in the control group. This observation suggests that M. chulae embryos mount a stress response when exposed to PHCZs. In summary, this study contributes to our understanding of the toxicological implications of PHCZ in marine fish and offers a theoretical foundation for risk assessment and regulatory frameworks for PHCZs in the marine environment.