Whole-exome sequencing reveals a comprehensive germline mutation landscape and identifies twelve novel predisposition genes in Chinese prostate cancer patients.

Prostate cancer is the most inheritable cancer with approximately 42% of disease risk attributed to inherited factors by studies of twins, indicating the importance of additional genetic screening to identify predisposition variants. However, only DNA damage repair (DDR) genes have been investigated thoroughly in prostate cancer. To determine the comprehensive germline mutation landscape in Chinese prostate cancer patients, we performed whole exome sequencing in 100 Han Chinese patients with prostate cancer in Hong Kong and identified deleterious germline mutations. A total of 36 deleterious germline variants in 25 genes were identified in 29% patients. Variants were found in eight pathways, including DNA methylation, DDR, and tyrosine-protein kinase. These findings were validated in an independent Chinese cohort of 167 patients with prostate cancer in Shanghai. Seven common deleterious-variant-containing genes were found in discovery cohort (7/25, 28%) and validation cohort (7/28, 25%) with three genes not described before (LDLR, MYH7 and SUGCT) and four genes previously reported (FANCI, ITGA6, PABPC1 and RAD54B). When comparing with that of a cohort of East Asian healthy individuals, 12 non-DDR novel potential predisposition genes (ADGRG1, CHD4, DNMT3A, ERBB3, GRHL1, HMBS, LDLR, MYH7, MYO6, NT5C2, NUP98 and SUGCT) were identified using the discovery and validation cohorts, which have not been previously reported in prostate cancer patients in all ethnic groups. Taken together, this study reveals a comprehensive germline mutation landscape in Chinese prostate cancer patients and discovers 12 novel non-DDR predisposition genes to lay the groundwork for the optimization of genetic screening.

Ferroelectric Aluminum Scandium Nitride Transistors with Intrinsic Switching Characteristics and Artificial Synaptic Functions for Neuromorphic Computing.

Aluminum Scandium Nitride (Al1-xScxN) has received attention for its exceptional ferroelectric properties, whereas the fundamental mechanism determining its dynamic response and reliability remains elusive. In this work, an unreported nucleation-based polarization switching mechanism in Al0.7Sc0.3N (AlScN) is unveiled, driven by its intrinsic ferroelectricity rooted in the ionic displacement. Fast polarization switching, characterized by a remarkably low characteristic time of 0.00183 ps, is captured, and effectively simulated using a nucleation-limited switching (NLS) model, where the profound effect of defects on the nucleation and domain propagation is systematically studied. These findings are further integrated into Monte Carlo simulations to unravel the influence of the activation energy for ferroelectric switching on the distributions of switching thresholds. The long-term reliability of devices is also confirmed by time-dependent dielectric breakdown (TDDB) measurements, and the effect of thickness scaling is discussed. Ferroelectric field-effect transistors (FeFETs) are demonstrated through the integration of AlScN and 2D MoS2 channel, where biological synaptic functions can be emulated with optimized operation voltage. The artificial neural network built from AlScN-based FeFETs achieves 93.8% recognition accuracy of handwritten digits, demonstrating the potential of ferroelectric AlScN in future neuromorphic computing applications.

Suppression of wavelength-dependent polarization fading using hybrid-polarization scheme in OFDR.

What we believe to be a new hybrid-polarization diversity scheme which can eliminate the polarization state variation caused by wavelength tuning of laser in optical frequency domain reflectometry is proposed in the paper. In the scheme, a 45° polarizer is used to maintain the polarization of signals. It decreases the polarization angle fluctuation to 2.81° and realizes a -145 dB test sensitivity with a 32 dB Rayleigh scattering signal-to-noise ratio in a 10 m fiber single test. The polarization fading suppression is achieved for tests with a large wavelength tuning range from 1480 nm to 1640 nm. Meanwhile, a 6 µm spatial resolution is also achieved. The proposed scheme can be applied to the structure measurement of high-precision optical fiber devices with high spatial resolution and sensitivity.

Protocol for CHAMPION study: a prospective study of maximal-cytoreductive therapies for patients with de novo metastatic hormone-sensitive prostate cancer who achieve oligopersistent metastases during systemic treatment with apalutamide plus androgen deprivation therapy.

BACKGROUND: The proposed trial is to examine the feasibility of prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT)-guided cytoreduction plus apalutamide and androgen deprivation therapy (ADT) for newly diagnosed metastatic hormone-sensitive prostate cancer (mHSPC) at oligometastatic state. METHODS: CHAMPION (NCT05717582) is an open-label, single-arm, phase II trial, planning to enroll newly diagnosed mHSPC cases with oligometastases (≤ 10 distant metastatic sites in conventional imaging). Patients will receive 6 cycles of apalutamide plus ADT. Patients with oligometastatic disease at PSMA PET/CT after 3 treatment cycles will receive cytoreductive radical prostatectomy. PSMA PET/CT-guided metastasis-directed external radiation therapy will be determined by the investigators. Apalutamide plus ADT will be continued for 2 weeks postoperatively. The primary endpoint is the proportion of patients with undetectable prostate-specific antigen (PSA), no disease progression, and no symptom deterioration after 6 cycles of apalutamide plus ADT. Secondary endpoints include the percentage of patients with PSA ≤ 0.2 ng/mL and oligometastases by the end of 3 treatment cycles, PSA response rate, and safety. Fleming's two-stage group sequential design will be adopted in the study, where the null hypothesis is that the rate of patients with an undetectable PSA is ≤ 40% after 6 cycles of treatment, while the alternate hypothesis is an undetectable PSA of > 60%; with one-sided α = 0.05, power = 0.80, and an assumed dropout rate of 10%, the required number of patients for an effective analysis is 47. Enrolment in the study commenced in May 2023. DISCUSSION: The multi-modal therapy based on treatment response may improve the prognosis of newly diagnosed mHSPC patients with oligometastases. TRIAL REGISTRATION: The study is registered with Clinical Trials.Gov (NCT05717582). Registered on 8th February 2023.

Support Platform of Functionalized Sustainable Cellulose Self-Entanglement Monolithic Adsorbents for Efficient Adsorption of Cadmium(II) Ions.

Serious water contamination induced by massive discharge of cadmium(II) ions is becoming an emergent environmental issue due to high toxicity and bioaccumulation; thus, it is extremely urgent to develop functional materials for effectively treating with Cd2+ from wastewater. Benefiting from abundant binding sites, simple preparation process, and adjustable structure, UiO-66-type metal-organic frameworks (MOFs) had emerged as promising candidates in heavy metal adsorption. Herein, monolithic UiO-66-(COOH)2-functionalized cellulose fiber (UCLF) adsorbents were simply fabricated by incorporating MOFs into cellulose membranes through physical blending and self-entanglement. A two-dimensional structure was facilely constructed by cellulose fibers from sustainable biomass agricultural waste, providing a support platform for the integration of eco-friendly UiO-66-(COOH)2 synthesized with lower temperature and toxicity solvent. Structure characterization and bath experiments were performed to determine operational conditions for the maximization of adsorption capacity, thereby bringing out an excellent adsorption capacity of 96.10 mg/g. UCLF adsorbent holding 10 wt % loadings of UiO-66-(COOH)2 (UCLF-2) exhibited higher adsorption capacity toward Cd2+ as compared to other related adsorbents. Based on kinetics, isotherms, and thermodynamics, the adsorption behavior was spontaneous, exothermic, as well as monolayer chemisorption. Coordination and electrostatic attraction were perhaps mechanisms involved in the adsorption process, deeply unveiled by the effects of adsorbate solution pH and X-ray photoelectron spectroscopy. Moreover, UCLF-2 adsorbent with good mechanical strength offered a structural guarantee for the successful implementation of practical applications. This study manifested the feasibility of UCLF adsorbents used for Cd2+ adsorption and unveiled a novel strategy to shape MOF materials for wastewater decontamination.

Birnessite-Type MnO2 Modified Sustainable Biomass Fiber toward Adsorption Removal Heavy Metal Ion from Actual River Aquatic Environment.

In this work, a novel birnessite-type MnO2 modified corn husk sustainable biomass fiber (MnO2@CHF) adsorbent was fabricated for efficient cadmium (Cd) removal from aquatic environments. MnO2@CHF was designed from KMnO4 hydrothermally treated with corn husk fibers. Various characterization revealed that MnO2@CHF possessed the hierarchical structure nanosheets, large specific surface area, and multiple oxygen-containing functional groups. Batch adsorption experimental results indicated that the highest Cd (II) removal rate could be obtained at the optimal conditions of adsorbent amount of 0.200 g/L, adsorption time of 600 min, pH 6.00, and temperature of 40.0 °C. Adsorption isotherm and kinetics results showed that Cd (II) adsorption behavior on MnO2@CHF was a monolayer adsorption process and dominated by chemisorption and intraparticle diffusion. The optimum adsorption capacity (Langmuir model) of Cd (II) on MnO2@CHF was 23.0 mg/g, which was higher than those of other reported common biomass adsorbent materials. Further investigation indicated that the adsorption of Cd (II) on MnO2@CHF involved mainly ion exchange, surface complexation, redox reaction, and electrostatic attraction. Moreover, the maximum Cd (II) removal rate on MnO2@CHF from natural river samples (Xicheng Canal) could reach 59.2% during the first cycle test. This study showed that MnO2@CHF was an ideal candidate in Cd (II) practical application treatment, providing references for resource utilization of agricultural wastes for heavy metal removal.

Phase-Induced Strain Effect to Synthesize an Iron-Doped Orthogonal Cobalt Selenide Electrocatalyst for the Oxygen Evolution Reaction.

The etching effect has the capability to control atom doping and trigger phase transformation, thereby enhancing the electrocatalytic reaction. Herein, iron-doped cobalt selenide (Fe-CoSe2) nanoparticle-decorated carbon nanofibers (Fe-CoSe2/CNFs) are synthesized by assembling an FeCo-Prussian blue analogue (FeCo-PBA) cube precursor with polyacrylonitrile fibers and then treating with hydrochloric acid, followed by gas phase selenization. The Fe-CoSe2/CNFs catalyst exhibits a large surface area and a porous structure, facilitating the permeation of electrolytes. Moreover, orthorhombic CoSe2 is obtained, which is in favor of improving the oxygen evolution reaction (OER). By modulating the etching time, the ideal crystal phase and the optimal amount of the dopant (Fe) can be achieved, thus showing favorable OER activity. Specifically, the Fe-CoSe2/CNFs electrocatalyst enables high electrocatalytic activity for the OER with a low overpotential of 263 mV to drive a current density of 10 mA cm-2 in 1 M KOH. A small Tafel slope of 51 mV dec-1 shows fast charge transfer kinetics. Density functional theory (DFT) calculations reveal that Fe-doped orthorhombic CoSe2(111) can modulate the electron structure, contributing to OH- adsorption ability. Given this, a strategy for phase transformation induced by etching technology is proposed to improve the intrinsic activity of the catalyst.

Interface Engineering with the Coupling of a 3D Porous Structure Enables MoP2-NiCoP Heterostructure Nanosheets for Enhanced Alkaline Hydrogen Evolution Reaction.

One of the crucial parts of the electrochemically focused energy conversion and storage system is the hydrogen evolution reaction. The further exploration of electrocatalysts made of nonprecious metals could help to bring the technology closer to industrialization. Here, we present an effective hydrogen evolution reaction (HER) electrocatalyst that employs hydrothermal and phosphorization steps to create three-dimensional (3D) porous MoP2-NiCoP heterostructure nanosheets on nickel foam (MoP2-NiCoP/NF). H2O-dissociation and H-adsorption were effectively achieved due to the distinctive interface engineering between NiCoP and MoP2, which functions as a channel for immediate electron transfer. Compared to the single-component MoP2 and NiCoP, the synergistic interaction between the heterogeneous components coupling and the 3D porous structure enables MoP2-NiCoP/NF to exhibit satisfactory catalytic activity with an ultralow overpotential of 50 mV at 10 mA cm-2, which is close to the commercial Pt/C catalyst in alkaline media. More importantly, it exhibits good stability, with the ability to be electrolyzed in 1.0 M KOH electrolyte for 24 h without a significant change in overpotential. This study offers directions for the design of low-cost, high-activity, transition metal phosphides (TMPs)-based HER catalyst alternatives for future practical applications.

Integrated Heterogeneous Engineering with the Vacancy Defect of Porous CoPv-MoxPv Nanosheets for an Accelerated Hydrogen Evolution Reaction.

Electrochemical water splitting is a possible way of realizing sustainable and clean hydrogen production but is challenging, because a highly active and durable electrocatalyst is essential. In this work, we integrated heterogeneous engineering and vacancy defect strategies to design and fabricate a heterostructure electrocatalyst (CoPv-MoxPv/CNT) with abundant phosphorus vacancies attached to carbon nanotubes (CNTs). The vacancy defects enabled the optimization of the electronic structure; thereby, the electron-rich low-valent metal sites enhanced the ability of nonmetallic P to capture proton H. Meanwhile, the heterogeneous interface between bimetallic phosphides and CNTs realized rapid electron transfer. In addition, the Co, Mo, and P active species in the electrocatalytic process exposed increased amounts of active sites featuring porous nanosheet structures, which facilitated the adsorption of reaction intermediates and thus enhanced the hydrogen evolution reaction performance. In particular, the optimized CoPv-MoxPv/CNT catalyst possesses an overpotential of 138 mV at a current density of 10 mA cm-2 and long-term stability for 24 h. This work offers insights and possibilities for the engineering and exploration of transition metal-based electrocatalysts through combining multiple synergistic strategies.

Chemistry, Functionalization, and Applications of Recent Monoelemental Two-Dimensional Materials and Their Heterostructures.

The past decades have witnessed a rapid expansion in investigations of two-dimensional (2D) monoelemental materials (Xenes), which are promising materials in various fields, including applications in optoelectronic devices, biomedicine, catalysis, and energy storage. Apart from graphene and phosphorene, recently emerging 2D Xenes, specifically graphdiyne, borophene, arsenene, antimonene, bismuthene, and tellurene, have attracted considerable interest due to their unique optical, electrical, and catalytic properties, endowing them a broader range of intriguing applications. In this review, the structures and properties of these emerging Xenes are summarized based on theoretical and experimental results. The synthetic approaches for their fabrication, mainly bottom-up and top-down, are presented. Surface modification strategies are also shown. The wide applications of these emerging Xenes in nonlinear optical devices, optoelectronics, catalysis, biomedicine, and energy application are further discussed. Finally, this review concludes with an assessment of the current status, a description of existing scientific and application challenges, and a discussion of possible directions to advance this fertile field.

The value of computed tomography angiography for evaluation of left atrial enlargement in patients with persistent atrial fibrillation.

BACKGROUND: The post-processing technology of CTA offers significant advantages in evaluating left atrial enlargement (LAE) in patients with persistent atrial fibrillation (PAF). This study aims to identify parameters for rapidly and accurately diagnosing LAE in patients with PAF using CT cross-sections. METHODS: Left atrial pulmonary venous (PV) CT was performed to 300 PAF patients with dual-source CT, and left atrial volume (LAV), left atrial anteroposterior diameter (LAD1), left atrial transverse diameter (LAD2), and left atrial area (LAA) were measured in the ventricular end systolic (ES) and middle diastolic (MD). LA index (LAI) = LA parameter/body surface area (BSA). Left atrial volume index (LAVIES) > 77.7 ml/m2 was used as the reference standard for the LAE diagnosis. RESULTS: 227 patients were enrolled in the group, 101 (44.5%) of whom had LAE. LAVES and LAVMD (r = 0.983), LAVIES and LAVIMD (r = 0.984), LAAES and LAVIES (r = 0.817), LAAMD and LAVIES (r = 0.814) had strong positive correlations. The area under curve (AUC) showed that all measured parameters were suitable for diagnosing LAE, and the diagnostic efficacy was compared as follows: LAA/LAAI> LAD> the relative value index of LAD, LAD2> LAD1. LAA and LAAI demonstrated comparable diagnostic efficacy, with LAA being more readily available than LAAI. CONCLUSIONS: The axial LAA measured by CTA can be served as a parameter for the rapid and accurate diagnosis of LAE in patients with PAF.

Hybrid deep learning based prediction for water quality of plain watershed.

Establishing a highly reliable and accurate water quality prediction model is critical for effective water environment management. However, enhancing the performance of these predictive models continues to pose challenges, especially in the plain watershed with complex hydraulic conditions. This study aims to evaluate the efficacy of three traditional machine learning models versus three deep learning models in predicting the water quality of plain river networks and to develop a novel hybrid deep learning model to further improve prediction accuracy. The performance of the proposed model was assessed under various input feature sets and data temporal frequencies. The findings indicated that deep learning models outperformed traditional machine learning models in handling complex time series data. Long Short-Term Memory (LSTM) models improved the R2 by approximately 29% and lowered the Root Mean Square Error (RMSE) by about 48.6% on average. The hybrid Bayes-LSTM-GRU (Gated Recurrent Unit) model significantly enhanced prediction accuracy, reducing the average RMSE by 18.1% compared to the single LSTM model. Models trained on feature-selected datasets exhibited superior performance compared to those trained on original datasets. Higher temporal frequencies of input data generally provide more useful information. However, in datasets with numerous abrupt changes, increasing the temporal interval proves beneficial. Overall, the proposed hybrid deep learning model demonstrates an efficient and cost-effective method for improving water quality prediction performance, showing significant potential for application in managing water quality in plain watershed.

Clinical phenotype and genetic function analysis of a rare family with hereditary leiomyomatosis and renal cell carcinoma complicated with Birt-Hogg-Dubé syndrome.

To date, over 200 families with hereditary leiomyomatosis and renal cell carcinoma (HLRCC) and over 600 families with Birt-Hogg-Dubé (BHD) syndrome have been reported, with low incidence. Here, we describe a patient with suspected rare HLRCC complicated by BHD syndrome. The proband (II1) had characteristic cutaneous leiomyoma-like protrusions on the neck and back, a left renal mass and multiple right renal, liver and bilateral lung cysts. Three family members (I1, II2, II3) had a history of renal cancer and several of the aforementioned clinical features. Two family members (II1, II3) diagnosed with fumarate hydratase (FH)-deficient papillary RCC via pathological biopsy carried two heterozygous variants: FH (NM_000143.3) missense mutation c.1189G>A (p.Gly397Arg) and FLCN (NM_144997.5) frameshift mutation c.1579_1580insA (p.Arg527Glnfs*75). No family member carrying a single variant had renal tumours. In HEK293T cells transfected with mutant vectors, mRNA and protein expression after FLCN p.Arg527Glnfs*75 and FH p.Gly397Arg mutations were significantly lower than those in wild-type (WT) cells. Cell immunofluorescence showed altered protein localisation and reduced protein expression after FLCN p.Arg527Glnfs*75 mutation. The FH WT was uniformly distributed in the cytoplasm, whereas FH protein expression was reduced after the p.Gly397Arg mutation and scattered sporadically with altered cell localisation. Patients with two variants may have a significantly increased penetrance of RCC.

PICC tip dislodgement causing massive pleural effusion and atelectasis with acute respiratory failure: a case report.

Peripheral intravenous central catheter (PICC) is a common tool for intravenous infusion for children who need central venous access. Although it is safe for physicians and nurses to place, complications like infection, occlusion, phlebitis, and bleeding can occur. We report a 5-month-old infant who suffered respiratory failure caused by catheter malposition resulting in massive fluid infusion into the thoracic cavity. Point-of-care ultrasound (POCUS) was utilized to identify a massive pleural effusion that prompted urgent drainage. Complications related to PICC in pediatric patients are not common but difficult to immediately identify sometimes. Therefore, careful attention should be paid by physicians to identify and reduce the risk of complications associated with PICC. Thus, visual tools are strongly advised to enhance the safety of invasive procedures.

The role of nutrition in analysis of risk factors and short-term outcomes for late-onset necrotizing enterocolitis among very preterm infants: a nationwide, multicenter study in China.

BACKGROUND: Necrotizing enterocolitis (NEC) is a serious gastrointestinal disease, primarily affects preterm newborns and occurs after 7 days of life (late-onset NEC, LO-NEC). Unfortunately, over the past several decades, not much progress has been made in its treatment or prevention. This study aimed to analyze the risk factors for LO-NEC, and the impact of LO-NEC on short-term outcomes in very preterm infants (VPIs) with a focus on nutrition and different onset times. METHOD: Clinical data of VPIs were retrospectively collected from 28 hospitals in seven different regions of China from September 2019 to December 2020. A total of 2509 enrolled VPIs were divided into 2 groups: the LO-NEC group and non-LO-NEC group. The LO-NEC group was divided into 2 subgroups based on the onset time: LO-NEC occurring between 8 ~ 14d group and LO-NEC occurring after 14d group. Clinical characteristics, nutritional status, and the short-term clinical outcomes were analyzed and compared among these groups. RESULTS: Compared with the non-LO-NEC group, the LO-NEC group had a higher proportion of anemia, blood transfusion, and invasive mechanical ventilation (IMV) treatments before NEC; the LO-NEC group infants had a longer fasting time, required longer duration to achieve the target total caloric intake (110 kcal/kg) and regain birthweight, and showed slower weight growth velocity; the cumulative dose of the medium-chain and long-chain triglyceride (MCT/LCT) emulsion intake in the first week after birth was higher and breastfeeding rate was lower. Additionally, similar results including a higher proportion of IMV, lower breastfeeding rate, more MCT/LCT emulsion intake, slower growth velocity were also found in the LO-NEC group occurring between 8 ~ 14d when compared to the LO-NEC group occurring after 14 d (all (P < 0.05). After adjustment for the confounding factors, high proportion of breastfeeding were identified as protective factors and long fasting time before NEC were identified as risk factors for LO-NEC; early feeding were identified as protective factors and low gestational age, grade III ~ IV neonatal respiratory distress syndrome (NRDS), high accumulation of the MCT/LCT emulsion in the first week were identified as risk factors for LO-NEC occurring between 8 ~ 14d. Logistic regression analysis showed that LO-NEC was a risk factor for late-onset sepsis, parenteral nutrition-associated cholestasis, metabolic bone disease of prematurity, and extrauterine growth retardation. CONCLUSION: Actively preventing premature birth, standardizing the treatment of grade III ~ IV NRDS, and optimizing enteral and parenteral nutrition strategies may help reduce the risk of LO-NEC, especially those occurring between 8 ~ 14d, which may further ameliorate the short-term clinical outcome of VPIs. TRIAL REGISTRATION: ChiCTR1900023418 (26/05/2019).

Spillover and spillback: Linking daily job insecurity to next-day counterproductive work behavior.

Spillover effect theory posits that work stressors can have spillover effects into workers' home lives. Although job insecurity spillover into the home domain has been explored extensively, potential spillback effects into the work domain have not. We posit that daily job insecurity represents a negative subjective perception that can spillover into the home domain and lead to insomnia, which will damage the recovery of self-regulatory resources and make employees unable to regulate their own behavior, ultimately resulting in next-day counterproductive work behavior. We hypothesized that self-compassion, as an individual trait, weakens the spillover effect of job insecurity and moderates the indirect effect of job insecurity on next-day counterproductive work behavior via insomnia. Our analyses of data collected from 132 full-time employees across 10 consecutive working days showed that insomnia mediates the relationship between daily job insecurity and next-day counterproductive work behavior, and further showed that this relationship was moderated by self-compassion. Overall, our research captures the cascading effects of daily job insecurity and contributes to a more complete understanding of the spillover effect of job insecurity.

[Efficacy of therapeutic hypothermia on mild neonatal hypoxic-ischemic encephalopathy: a prospective randomized controlled study]. / æ–°ç”Ÿå„¿è½»åº¦ç¼ºæ°§ç¼ºè¡€æ€§è„‘ç— äºšä½Žæ¸©æ²»ç–—æ•ˆæžœçš„å‰çž»æ€§éšæœºå¯¹ç §ç ”ç©¶.

OBJECTIVES: To investigate the efficacy of therapeutic hypothermia on mild neonatal hypoxic-ischemic encephalopathy (HIE). METHODS: A prospective study was performed on 153 neonates with mild HIE who were born from September 2019 to September 2023. These neonates were randomly divided into two groups: therapeutic hypothermia (n=77) and non-therapeutic hypothermia group (n=76). The short-term clinical efficacy of the two groups were compared. Barkovich scoring system was used to analyze the severity of brain injury shown on magnetic resonance imaging (MRI) between the two groups. RESULTS: There were no significant differences in gestational age, gender, birth weight, mode of birth, and Apgar score between the therapeutic hypothermia and non-therapeutic hypothermia groups (P>0.05). There were no significant differences in the incidence rates of sepsis, arrhythmia, persistent pulmonary hypertension and pulmonary hemorrhage and the duration of mechanical ventilation within the first 72 hours after birth between the two groups. The therapeutic hypothermia group had longer prothrombin time within the first 72 hours after birth and a longer hospital stay (P<0.05). Compared with the non-therapeutic hypothermia group, the therapeutic hypothermia group had lower incidence rates of MRI abnormalities (30% vs 57%), moderate to severe brain injury on MRI (5% vs 28%), and watershed injury (27% vs 51%) (P<0.05), as well as lower medium watershed injury score (0 vs 1) (P<0.05). CONCLUSIONS: Therapeutic hypothermia can reduce the incidence rates of MRI abnormalities and watershed injury, without obvious adverse effects, in neonates with mild HIE, suggesting that therapeutic hypothermia may be beneficial in neuroprotection in these neonates.

Prevalence of mismatch repair genes mutations and clinical activity of PD-1 therapy in Chinese prostate cancer patients.

Prostate cancer (PCa) patients with mismatch repair (MMR) genes mutations are potentially responsive to immune checkpoint blockade (ICB). However, aberrations in MMR genes were rare in PCa and there is evidence that MMR genes mutations are highly ethnic specific. Thus, the prevalence and clinical characteristics of this subgroup in Chinese PCa patients are largely unknown. Furthermore, why some of these patients do not respond to ICB also remains unclear. Here, we analyzed the sequencing data from 3338 Chinese PCa patients to profile the mutation spectrum of the MMR genes. We found that in metastatic disease, the pathogenic mutation frequency of MMR genes in Chinese PCa patients was higher than that in the Caucasus population (4.8 vs 2.2%, P = 0.006) and the mutation carriers responded poorer to androgen deprive therapy (ADT) and abiraterone than non-carriers. Besides, we reported a multi-institutional cases series of 11 PCa patients with mismatch repair deficiency (dMMR) or microsatellite instability high (MSI-H) who received programmed cell death receptor-1 (PD-1) inhibitors, and performed multiplex immunohistochemistry (mIF) to explore the relationship between tumor immune microenvironment (TIME) and response to ICB. The results showed that the responders had higher density of intratumoral CD8+ T cells than non-responders. Our data suggested MMR genes mutations may be more common in Chinese PCa patients, and it is associated with poorer response to hormonal therapies. We propose that the density of intratumoral CD8+ T cells could be a promising predictor to help further subdivide the population of PCa patients who can benefit from immunotherapy.

Characterization of an optrA-harbouring unconventional circularizable structure located on a novel ICESa2603 family-like integrative and conjugative element ICESsuHN38 in Streptococcus suis.

OBJECTIVES: To identify the novel genetic elements involved in the horizontal transfer of the oxazolidinone/phenicol resistance gene optrA in Streptococcus suis. METHODS: Whole-genome DNA of the optrA-positive isolate S. suis HN38 was subjected to WGS via both Illumina HiSeq and Oxford Nanopore platforms. MICs of several antimicrobial agents (erythromycin, linezolid, chloramphenicol, florfenicol, rifampicin and tetracycline) were determined by broth microdilution. PCR assays were performed to identify the circular forms of the novel integrative and conjugative element (ICE) ICESsuHN38, but also the unconventional circularizable structure (UCS) excised from this ICE. The transferability of ICESsuHN38 was evaluated by conjugation assays. RESULTS: S. suis isolate HN38 harboured the oxazolidinone/phenicol resistance gene optrA. The optrA gene was flanked by two copies of erm(B) genes in the same orientation, located on a novel ICESa2603 family-like ICE, designated ICESsuHN38. PCR assays revealed that a novel UCS carrying the optrA and one copy of erm(B) could be excised from ICESsuHN38. Conjugation assays confirmed that ICESsuHN38 was able to successfully transfer into the recipient strain S. suis BAA. CONCLUSIONS: In this work, a novel optrA-carrying mobile genetic element, a UCS, was identified in S. suis. The optrA gene was flanked by copies of erm(B) and its location on the novel ICESsuHN38 will aid its horizontal dissemination.

Concomitant vs Staged Therapeutic Inguinal Lymphadenectomy in Clinically Node Positive Penile Squamous Cell Carcinoma: Does It Make a Difference?

PURPOSE: Inguinal lymph node dissection within 3 months of primary tumor resection in penile cancer has been associated with longer recurrence-free and cancer-specific survival. However, the optimal timing and effect of lymphadenectomy performed concurrently at the time of primary lesion management on oncologic outcomes in clinically lymph node positive penile squamous cell carcinoma remains unknown. MATERIALS AND METHODS: An international, multicenter cohort of 966 penile cancer cases was queried for penile squamous cell carcinoma management after the year 2000, clinically lymph node positive status, and performance of penile surgery and inguinal lymph node dissection. Cohorts were stratified as concomitant if inguinal lymph node dissection and penile surgery occurred on the same date or staged when inguinal lymph node dissection was performed after penile resection. Rates and patterns of penile squamous cell carcinoma recurrence were reported. Distant recurrence-free, cancer-specific, and overall survival were estimated using Kaplan-Meier analyses and groups compared with log-rank testing. RESULTS: Of 253 contemporary men with clinically lymph node positive penile squamous cell carcinoma, 96 (38%) underwent concomitant inguinal lymph node dissection and 157 (62%) had inguinal lymph node dissection performed in a staged manner. Penile cancer was most likely to recur distantly (19%) followed by in the groin (14%) or pelvis (5%). There were no differences in distant recurrence-free, cancer-specific, or overall survival between management strategies. Multivariable analysis adjusting for stage, treatment center, and perioperative chemoradiation also demonstrated no recurrence-free, cancer-specific, or overall survival benefit between management strategies. CONCLUSIONS: Inguinal lymph node dissection performed concurrently with excision of the penile tumor for clinically node positive penile squamous cell carcinoma is not associated with differences in recurrence-free, cancer-specific, or overall survival compared to staged lymph node dissection.