Effects of minimum monitor unit per dynamic control point on intensity-modulated radiotherapy planning for nasopharyngeal carcinoma: A retrospective study.

The present study aimed to improve the dose distribution of radiotherapy planning for nasopharyngeal carcinoma (NPC) by comparing the effects of various minimum monitor units (MUs) per dynamic control point (MMCP) values on the quality and execution efficiency of dynamic intensity-modulated radiotherapy (IMRT) planning. Thirty-four clinically implemented dynamic IMRT plans for patients with NPC were retrospectively selected. In total, 170 plans were obtained by modifying only the MMCP values (set as 1, 3, 5, 7, and 9) in the treatment planning system's (TPS) optimization parameters. These plans were divided into 5 groups. Analyzing the effects of MMCP on the target and organ dose at risk (OAR), also the execution efficiency of the treatment plan in each group and using a quality score system, we conducted an objective quantitative study of the dose distribution and execution efficiency. The target dose evaluation indicators (target coverage (TC), homogeneity index (HI), and conformity index (CI)) of all IMRT plans showed a trend of variation with an increase in MMCP values, and the difference was statistically significant when MMCP values were 5, 7, 9, and 1 (p < 0.05). With an increase in MMCP, the dose to OAR slightly increased, but the difference was not statistically significant (p > 0.05). With an increase in MMCP, the average number of MUs per segment significantly increased (p < 0.01). The groups based on MMCP values of 1, 3, 5, 7, and 9 received quality score system of 1.188, 1.180, 1.171, 0.987, and 1.184, respectively, with the MMCP7 group achieving the lowest score, indicating that this plan had the highest overall quality. The MMCP value for dynamic IMRT planning in the Monaco TPS for patients with NPC should be set to 7 to achieve fewer segments, the best execution efficiency without significantly deteriorating the target and OAR dose.

Dismountable Protein Corona-Modified Virus-Like Manganese-Arsenic Nanomedicine Enables Safe and Targeted Delivery for Synergistic Arsenotherapy.

Arsenic agents have shown great potential in fighting leukemia, but are poorly known in treating solid tumors, mainly ascribing to the rapid clearance and low targeting ability. It is reported that morphology modulation can enhance the interaction between nanoparticles and cell membrane. Herein, a dismountable protein corona-modified virus-like manganese-arsenic nanomedicine (vMnAs@HR) is rationally proposed for realizing safe and targeted delivery and synergistic arsenotherapy. The virus-like manganese-arsenic nanoparticle (vMnAs) is constructed followed by modification of a temporary R848-loaded HDL (HR) protein corona. Upon intravenous injection, the HR protein corona is stable and actively targeted to tumor tissue by taking advantage of the interaction between HDL and its receptor SR-BI. Intriguingly, upon accumulated in the tumor, HR can be jettisoned and interacted with macrophages for proinflammatory phenotype modulation. The re-exposed vMnAs can efficiently enhance endocytosis by taking advantage of the rationally designed spiky morphology. Moreover, the released double-stranded DNA (dsDNA) and manganese ions during tumor cell apoptosis can cooperatively activate cyclic guanosine monophosphate adenosine monophosphate synthase (cGAS)-stimulator of interferon genes (STING) signaling pathway of DCs for systematic immune activation. It is anticipated that this morphology-transformable nanomedicine can realize safe and efficient arsenic delivery for synergistic arsenotherapy.

Mediation effect of knowledge management on the impact of IT capability on firm performance: exploring the moderating role of organization culture management.

Introduction: With the development of the digital economy, a multitude of firms have embarked on the path of digital transformation through information technology (IT). Scholars have called for attention to the mediating or moderating mechanisms of IT capability on firm performance. This study argues that further exploration is needed regarding the relationship between IT capability and firm performance. Methods: This study obtained questionnaire data from 152 IT senior managers of randomly selected manufacturing firms. The data was used to empirically test the proposed hypotheses using hierarchical regression analysis. Results: The results showed that IT capability has a positive effect on firm performance directly and indirectly via knowledge stock and knowledge process. Moreover, organizational culture management moderates the relationship between knowledge stock/knowledge process, and firm performance. Discussion: This study proposes the "resources-knowledge-performance" mechanism, which sheds light on the "black box" of how IT capability affects firm performance. This enriches the research on knowledge from different perspectives and the the research on organizational culture by discussing the moderating role of organizational culture management in the relationship between knowledge stock/process and firm performance. Our research also has important managerial implications to firm.

Clinical diagnostic value of metagenomic next-generation sequencing in patients with acute infection in emergency department.

Objective: To explore the value of metagenomic next-generation sequencing (mNGS) and culture in microbial diagnosis of patients with acute infection. Methods: We retrospectively analyzed 206 specimens from 163 patients who were admitted to the emergency department of The First Affiliated Hospital of Sun Yat-sen University between July 2020, and July 2021. We evaluated the diagnostic efficacy of mNGS and in-hospital traditional culture. Results: The total positive rate of mNGS was significantly higher than that culture methods (71.4 % vs 40.8 %, p < 0.001), while the sensitivity and accuracy of mNGS were found to be 92.9 % and 88.2 % respectively. However, culture exhibited superior specificity with a value of 92.6 % compared to 75.9 % for mNGS. The detection efficiency of mNGS and culture for fungi was comparable, but mNGS showed superior performance for bacterial detection. In the analysis of sepsis samples, mNGS outperformed traditional culture methods in diagnosing various types of samples, especially for sputum and bronchoalveolar lavage fluid. Among the identified infections, bacterial infections were the most common single infection (37.5 %). Additionally, bacterial-fungal infections represented the most prevalent form of mixed infection (77.3 %). Candida albicans and Staphylococcus aureus were identified as the predominant pathogens in the survival and death groups, respectively. No significant differences in microbial diversity were observed. Conclusion: Compared to culture methods, mNGS demonstrates superior positive rates, sensitivity, and accuracy in the rapid detection of acute infections, particularly in critically ill patients such as those with sepsis. This capability establishes a foundation for the swift and precise identification of pathogens, allowing for the analysis of clinical indicators and patient prognosis based on the extensive data generated from mNGS.

Novel Supramolecular Hydrogel for Infected Diabetic Foot Ulcer Treatment.

Multifunctional responsive hydrogels hold significant promise for diabetic foot ulcer (DFU) treatment, though their complex design and manufacturing present challenges. This study introduces a novel supramolecular guanosine-phenylboronic-chlorogenic acid (GBC) hydrogel developed using a dynamic covalent strategy. The hydrogel forms through guanosine quadruplex assembly in the presence of potassium ions and chlorogenic acid (CA) linkage via dynamic borate bonds. GBC hydrogels exhibit pH and glucose responsiveness, releasing more chlorogenic acid under acidic and high glucose conditions due to borate bond dissociation and G-quadruplex (G4) hydrogel disintegration. Experimental results indicate that GBC hydrogels exhibit good self-healing, shear-thinning, injectability, and swelling properties. Both in vitro and in vivo studies demonstrate the GBC hydrogel's good biocompatibility, ability to eliminate bacteria and reactive oxygen species (ROS), facilitate macrophage polarization from the M1 phenotype to the M2 phenotype (decreasing CD86 expression and increasing CD206 expression), exhibit anti-inflammatory effects (reducing TNF-α expression and increasing IL-10 expression), and promote angiogenesis (increasing VEGF, CD31, and α-SMA expression). Thus, GBC hydrogels accelerate DFU healing and enhance tissue remodeling and collagen deposition. This work provides a new approach to developing responsive hydrogels to expedite DFU healing.

Micro-Computed Tomographic Analysis of Radicular Dentin Thickness in Mandibular Second Molars Across Diverse Anatomic Root Variations: Identifying Potential Danger Zones.

INTRODUCTION: This study aimed to investigate radicular dentin thicknesses in mandibular second molars (MSMs), considering variations in root configuration and the morphology of the pulp chamber floor (PCF). The types of radicular grooves and potential danger zones were also identified. METHODS: A total of 149 MSMs were scanned with micro-computed tomographic imaging and classified into 4 groups according to root fusion and PCF morphology as follows: (1) 45 with fused roots and C-shaped PCFs, (2) 45 with fused roots and non-C-shaped PCFs, (3) 14 with a single canal, and (4) 45 with separated roots. The first 2 groups were subdivided into Ω-shaped, U-shaped, and V-shaped radicular groove subgroups. Measurements included minimum and mean dentin thickness from the start of the radicular groove or root bifurcation extending 5 mm apically, the ratio of outer to inner dentin thickness, and the distribution of dentin thickness. RESULTS: Ω-shaped and U-shaped subgroups showed significant thinner minimum inner wall thickness than V-shaped subgroups at 2-5 mm from the starting point of the radicular groove in both C-shaped and non-C-shaped pulp floor categories (P < .05). The mesial roots of separated rooted MSMs showed significant thinner dentin than a non-C-shaped floor regarding minimum and mean inner thickness and mean outer thickness (P < .05). Teeth with a single canal had significantly thicker walls compared with the other 3 groups. CONCLUSIONS: In MSMs, caution must be exercised, especially in the presence of Ω-shaped and U-shaped grooves in C-shaped roots and around the root furcation of separated roots.

Magnetic Nanocomposite Modified Hybrid Hole-Transport Layer for Constructing Organic Solar Cells with High Efficiencies.

An interface modification layer holds paramount significance in reducing interface carrier recombination and improving the ohmic contact between the active layer and the electrode in organic solar cells (OSCs). Modifying or doping the widely used hole-transport layer (HTL) PEDOT:PSS to adjust the work function, conductivity, and acidity has become a common strategy for achieving high-performance OSCs. Metal oxides and two-dimensional materials as secondary dopants into PEDOT:PSS, respectively, as well as a replacement of PEDOT:PSS both exhibit immense potential for achieving high-performance OSCs due to their excellent electrical properties. Herein, we report a method utilizing a Fe3O4/GO magnetic nanocomposite as a secondary dopant for PEDOT:PSS to modulate its inherent properties for constructing high-efficiency OSCs. The magnetic nanocomposite hybrid HTL exhibits a suitable optical transmittance and higher work function. Meanwhile, it is found that the addition of Fe3O4/GO magnetic nanoparticles expands the domain of PEDOT and enhances the phase separation between PEDOT and PSS segments, thereby improving the conductivity of PEDOT:PSS. By fine-tuning the doping ratio of a Fe3O4/GO magnetic nanocomposite in PEDOT:PSS, the best power conversion efficiency of OSCs based on PM6:L8-BO was up to 18.91%. The notable enhancement of the device's performance was due to the enhanced hole mobility and the improved charge extraction, further complemented by the decreased likelihood of interface recombination brought about by the hybrid HTL. Compared with PEDOT:PSS-based OSCs, an enhanced stability of the hybrid HTL-based device was also obtained. In addition, the diverse adaptability of the hybrid HTL was demonstrated in enhancing the performance of OSCs that are based on PM6:Y6 and PBDB-T:ITIC. The effectiveness and versatility of a magnetic nanocomposite hybrid HTL present opportunities for achieving high-performance OSCs.

Rheological Behavior of SiO2 Ceramic Slurry in Stereolithography and Its Prediction Model Based on POA-DELM.

Ceramic slurry is the raw material used in stereolithography, and its performance determines the printing quality. Rheological behavior, one of the most important physical factors in stereolithography, is critical in ceramic printing, significantly affecting the flow, spreading, and printing processes. The rheological behavior of SiO2 slurry used in stereolithography technology is investigated in the current research using different powder diameters and temperatures. The results present the apparent non-Newtonian behavior. The yielding characteristics occur in all cases. For single-powder cases, the viscosity decreases when the powder diameter is increased. When the nano-sized and micro-sized powders are mixed in different proportions, a more significant proportion of micron-sized powders will decrease the viscosity. With an increase in the nano-sized powders, the slurry exhibits the shear thinning behavior; otherwise, the shear thickening behavior is observed. Thus, the prediction model is built based on the use of the pelican optimization algorithm-deep extreme learning machine (POA-DELM), and the model in then compared with the fitted and traditional models to validate the effectiveness of the method. A more accurate viscosity prediction model will contribute to better fluid dynamic simulation in future work.

Efficacy and safety of avatrombopag in the treatment of thrombocytopenia after umbilical cord blood transplantation.

BACKGROUND: Delayed platelet engraftment is a common complication after umbilical cord blood transplantation (UCBT), and there is no standard therapy. Avatrombopag (AVA) is a second-generation thrombopoietin (TPO) receptor agonist (TPO-RA) that has shown efficacy in immune thrombocytopenia (ITP). However, few reports have focused on its efficacy in patients diagnosed with thrombocytopenia after allogeneic hematopoietic stem cell transplantation (allo-HSCT). METHODS: We conducted a retrospective study to evaluate the efficacy of AVA as a first-line TPO-RA in 65 patients after UCBT; these patients were compared with 118 historical controls. Response rates, platelet counts, megakaryocyte counts in bone marrow, bleeding events, adverse events and survival rates were evaluated in this study. Platelet reconstitution differences were compared between different medication groups. Multivariable analysis was used to explore the independent beneficial factors for platelet implantation. RESULTS: Fifty-two patients were given AVA within 30 days post-UCBT, and the treatment was continued for more than 7 days to promote platelet engraftment (AVA group); the other 13 patients were given AVA for secondary failure of platelet recovery (SFPR group). The median time to platelet engraftment was shorter in the AVA group than in the historical control group (32.5 days vs. 38.0 days, Z = 2.095, P = 0.036). Among the 52 patients in the AVA group, 46 achieved an overall response (OR) (88.5%), and the cumulative incidence of OR was 91.9%. Patients treated with AVA only had a greater 60-day cumulative incidence of platelet engraftment than patients treated with recombinant human thrombopoietin (rhTPO) only or rhTPO combined with AVA (95.2% vs. 84.5% vs. 80.6%, P <0.001). Patients suffering from SFPR had a slightly better cumulative incidence of OR (100%, P = 0.104). Patients who initiated AVA treatment within 14 days post-UCBT had a better 60-day cumulative incidence of platelet engraftment than did those who received AVA after 14 days post-UCBT (96.6% vs. 73.9%, P = 0.003). CONCLUSION: In summary, compared with those in the historical control group, our results indicate that AVA could effectively promote platelet engraftment and recovery after UCBT, especially when used in the early period (≤14 days post-UCBT).

Dynamics of symptom network in patients with first-episode schizophrenia: Insight from the CNFEST project.

BACKGROUND: Schizophrenia is a heterogeneous psychotic disorder. Recent theories have emphasized the importance of interactions among psychiatric symptoms in understanding the pathological mechanisms of schizophrenia. In the current study, we examined the symptom network in patients with first-episode schizophrenia (FES) at four time points during a six-month follow-up period. METHODS: In total, 565 patients with FES were recruited from the Chinese First-Episode Schizophrenia Trial (CNFEST) project. Clinical symptoms were measured using the Positive and Negative Syndrome Scale (PANSS) at baseline and follow-up (514 patients at one month, 429 at three months, and 392 at six months). We used a network analysis approach to estimate symptom networks with individual symptoms as nodes and partial correlation coefficients between symptoms as edges. A cross-lagged panel network (CLPN) model was used to identify predictive pathways for clinical symptoms. RESULTS: We found stable and strongly connected edges in patients across the time points, such as links between delusions and suspiciousness/persecution (P1:P6), and emotional withdrawal and passive/apathetic social withdrawal (N2:N4). Emotional withdrawal (N2), poor rapport (N3), and passive/apathetic social withdrawal (N4) had high centrality estimates across all four time points. CLPN analysis showed that negative symptoms, including emotional withdrawal (N2), poor rapport (N3), and passive/apathetic social withdrawal (N4), and stereotyped thinking (N7) may have predictive effects for negative and general symptoms at follow-ups. CONCLUSIONS: The symptom network of schizophrenia may be dynamic as treatment progresses. Negative symptoms remain the central and stable symptoms of schizophrenia. Negative symptoms may be potential therapeutic targets that predict other symptoms.

Dipole Moment Modulation of Terminal Groups Enables Asymmetric Acceptors Featuring Medium Bandgap for Efficient and Stable Ternary Organic Solar Cells.

This study puts forth a novel terminal group design to develop medium-bandgap Y-series acceptors beyond conventional side-chain engineering. We focused on the strategical integration of an electron-donating methoxy group and an electron-withdrawing halogen atom at benzene-fused terminal groups. This combination precisely modulated the dipole moment and electron density of terminal groups, effectively attenuating intramolecular charge transfer effect, and widening the bandgap of acceptors. The incorporation of these terminal groups yielded two asymmetric acceptors, named BTP-2FClO and BTP-2FBrO, both of which exhibited open-circuit voltage (VOC) as high as 0.96 V in binary devices, representing the highest VOCs among the asymmetric Y-series small molecule acceptors. More importantly, both BTP-2FClO and BTP-2FBrO exhibit modest aggregation behaviors and molecular crystallinity, making them suitable as a third component to mitigate excess aggregation of the PM6: BTP-eC9 blend and optimize the devices' morphology. As a result, the optimized BTP-2FClO-based ternary organic solar cells (OSCs) achieved a remarkable power conversion efficiency (PCE) of 19.34%, positioning it among the highest-performing OSCs. Our study highlights the molecular design importance on manipulating dipole moments and electron density in developing medium-bandgap acceptors, and offers a highly efficient third component for high-performance ternary OSCs.

Direct and interaction effects of CEO academic experience and CEO duality on digital transformation.

We used regression analysis to examine the direct and interaction effects of CEO academic experience and CEO duality on digital transformation in order to explain why firms vary in their digital transformation. Data analysis of manufacturing firms listed on the A-share market of the Shanghai and Shenzhen stock exchanges from 2007 to 2022 reveals that both academic experience and duality have significant positive direct effects on digital transformation. Both variables also mutually interact to promote digital transformation. This study not only makes an important contribution to the research on digital transformation and upper echelons theory but also provides useful guidance for firms developing their digitization strategy.

KCNE4 is a crucial host factor for Orf virus infection by mediating viral entry.

The orf virus (ORFV) poses a serious threat to the health of domestic small ruminants (i.e., sheep and goats) and humans on a global scale, causing around $150 million in annual losses to livestock industry. However, the host factors involved in ORFV infection and replication are still elusive. In this study, we compared the RNA-seq profiles of ORFV-infected or non-infected sheep testicular interstitial cells (STICs) and identified a novel host gene, potassium voltage-gated channel subfamily E member 4 (KCNE4), as a key host factor involved in the ORFV infection. Both RNA-seq data and RT-qPCR assay revealed a significant increase in the expression of KCNE4 in the infected STICs from 9 to 48 h post infection (hpi). On the other hand, the RT-qPCR assay detected a decrease in ORFV copy number in both the STICs transfected by KCNE4 siRNA and the KCNE4 knockout (KO) HeLa cells after the ORFV infection, together with a reduced fluorescence ratio of ORFV-GFP in the KO HeLa cells at 24 hpi, indicating KCNE4 to be critical for the ORFV infection. Furthermore, the attachment and internalization assays showed decreased ORFV attachment, internalization, replication, and release by the KO HeLa cells, demonstrating a potential inhibition of ORFV entry into the cells by KCNE4. Pretreatment with the KCNE4 inhibitors such as quinidine and fluoxetine significantly repressed the ORFV infection. All our findings reveal KCNE4 as a novel host regulator of the ORFV entry and replication, shedding new insight into the interactive mechanism of ORFV infection. The study also highlights the K+ channels as possible druggable targets to impede viral infection and disease.

The genetic characterization of germplasm and identification of the litter size trait associated candidate genes in Dexin mutton and fine-wool sheep.

Xinjiang is a major province of sheep breeding in China, which plays an important role in meeting people's needs for meat products, increasing farmers' income and sustainable development of animal husbandry. However, the genetic differentiation relationship between breeds was not clear, and most sheep had low fecundity, which seriously restricted the efficient development of sheep industry. Therefore, this study used the whole genome resequencing to detect the genetic variation of Dexin mutton and fine-wool sheep, explored the selected regions and important genes of the litter size traits, analyzed the genetic mechanism of reproductive traits, and provided new insights for the high fecundity breeding of sheep. A total of 5,236.338 G genome data and 35,884,037 SNPs were obtained. Furthermore, we identified 39 selection signals spanning candidate genes, 99 genes were significantly associated related to growth, reproduction and immunity, among which, BRIP1, BMPR1B, BMP4, NGF, etc. genes, and MAKP signaling pathway, Fanconi anemia pathway and Thyroid hormone signaling pathway and other signaling pathways were significantly correlated with litter size trait. Among them, we identified NGF, TrKA and BRIP1 genes was the important genes for sheep litter size traits and the mutation frequencies of 9 SNPs in BRIP1 gene were significantly different in domestic sheep in the world. The research provided new insights for the breeding of self-cultivated meat fine-wool sheep.

A Biomimetic Nanocarrier Strategy Targets Ferroptosis and Efferocytosis During Myocardial Infarction.

Background: Myocardial infarction (MI) is characterized by irreversible cardiomyocyte death resulting from an inadequate supply of oxygenated blood to the myocardium. Recent studies have indicated that ferroptosis, a form of regulated cell death, exacerbates myocardial injury during MI. Concurrently, the upregulation of CD47 on the surface of damaged myocardium following MI impairs the clearance of dead cells by macrophages, thereby hindering efferocytosis. In this context, simultaneously inhibiting ferroptosis and enhancing efferocytosis may represent a promising strategy to mitigate myocardial damage post-MI. Methods: In this study, we engineered platelet membrane-coated hollow mesoporous silicon nanoparticles (HMSN) to serve as a drug delivery system, encapsulating ferroptosis inhibitor, Ferrostatin-1, along with an anti-CD47 antibody. We aimed to assess the potential of these nanoparticles (designated as Fer-aCD47@PHMSN) to specifically target the site of MI and evaluate their efficacy in reducing cardiomyocyte death and inflammation. Results: The platelet membrane coating on the nanoparticles significantly enhanced their ability to successfully target the site of myocardial infarction (MI). Our findings demonstrate that treatment with Fer-aCD47@PHMSN resulted in a 38.5% reduction in cardiomyocyte ferroptosis under hypoxia, indicated by decreased lipid peroxidation and increased in vitro. Additionally, Fer-aCD47@PHMSN improved cardiomyocyte efferocytosis by approximately 15% in vitro. In MI mice treated with Fer-aCD47@PHMSN, we observed a substantial reduction in cardiomyocyte death (nearly 30%), decreased inflammation, and significant improvement in cardiac function. Conclusion: Our results demonstrated that the cooperation between the two agents induced anti-ferroptosis effects and enhanced dead cardiomyocyte clearance by macrophage as well as anti-inflammation effects. Thus, our nanoparticle Fer-aCD47@PHMSN provides a new therapeutic strategy for targeted therapy of MI.

Association of Controlling Nutritional Status Score With Mortality in Patients With Chronic Limb-Threatening Ischemia Following Endovascular Revascularization.

BACKGROUND: Chronic limb-threatening ischemia (CLTI) represents the severest manifestation of peripheral artery disease. Malnutrition is closely associated with poor clinical outcomes in patients with chronic diseases. The Controlling Nutritional Status (CONUT) score is a tool to evaluate the systemic inflammation and nutritional status. This study aimed to investigate the association of baseline CONUT score with mortality in patients with CLTI following endovascular revascularization. METHODS: A single-center retrospective analysis of patients with CLTI undergoing endovascular revascularization between January 2015 and December 2022 was performed. Preoperative nutritional status was evaluated using CONUT score, which was calculated using the serum albumin concentration, total peripheral lymphocyte count, and total cholesterol concentration. A CONUT score ≥5 indicates moderate or severe malnutrition. The Kaplan-Meier and multivariate Cox proportional hazards regression were used for survival analysis and to evaluate the risk factors associated with mortality. RESULTS: Among 232 enrolled patients, 20.7% had moderate or severe malnutrition defined by the CONUT score. During a median follow-up of 2.1 (interquartile ranges, 1.0-3.5) years, 87 (37.5%) patients died. The 3-year overall survival rate in patients with CLTI who underwent endovascular revascularization was 63.7%. The high CONUT (≥5) group had significantly worse 3-year overall survival (42.0% vs. 68.8%, P = 0.004) and limb salvage (73.3% vs. 84.1%, P = 0.005) rates than the low CONUT (<5) group. Multivariate analysis showed that high CONUT score was significantly associated with increased risk for mortality in patients with CLTI after endovascular revascularization (hazard ratio, 1.687; 95% confidence interval, 1.031-2.759; P = 0.037). CONCLUSIONS: The present study indicated that moderate or severe malnutrition defined by the CONUT score was significantly associated with increased mortality in patients with CLTI following endovascular revascularization. Future study is required to evaluate the efficacy of nutritional intervention in these patients.

Clinicopathological features of hepatoid adenocarcinoma and non-hepatoid adenocarcinoma of the stomach: A systematic review and meta-analysis.

BACKGROUND: Hepatoid adenocarcinoma of the stomach (HAS) is an extremely rare and unique malignant gastric tumor with a significantly worse prognosis than non-hepatoid adenocarcinoma of the stomach (non-HAS). The present study explored the clinicopathological features of HAS and non-HAS patients to provide insights into HAS treatment strategies. METHODS: From December 26, 2023, we performed a comprehensive search of the PubMed, Web of Science, Cochrane Library, and Embase.com databases for relevant studies. Two authors independently screened the studies, evaluated their quality, extracted data, and performed the analyses. This study was registered with PROSPERO on January 2, 2024. RESULTS: Nine retrospective studies were included for analysis after screening 833 articles. A total of 350 and 924 patients were enrolled in the HAS and non-HAS groups, respectively. While no significant differences were observed in age, sex, tumor size, T3 or T4 stage, and N2 or N3 stage between the two groups, the HAS group exhibited higher rates of lymph node metastasis (OR = 1.93, 95% CI: 1.19-3.13, p = 0.007), liver metastasis (OR = 3.45, 95% CI: 2.26-5.28, p < 0.001), and vascular invasion (OR = 2.76, 95% CI: 2.05-3.71, p < 0.001). Additionally, the HAS group had lower 3-year survival rates (HR = 2.35, 95% CI: 1.70-3.25, p < 0.001) and 5-year survival rates (HR = 3.63, 95% CI: 1.49-8.88, p = 0.005), but lower rates of lymphatic permeation (OR = 0.68, 95% CI: 0.47-0.99, p = 0.040). CONCLUSION: Based on the current clinical evidence, patients with HAS present distinct clinicopathological features, greater invasiveness, and poorer prognosis than non-HAS patients. Further research is warranted to develop optimal treatment strategies for HAS.

Vitamin C Alleviates the Risk of Gestational Diabetes Mellitus Associated With Exposure to Metals.

Background: Exposure to heavy metals has been suggested to increase the risk of gestational diabetes mellitus (GDM) through the oxidative stress pathway. The study is aimed at examining whether vitamin C could modify the association between exposure to heavy metals and risk of GDM. Methods: We conducted a case-control study in Taiyuan, China, with 776 GDM cases and 776 controls. Data on vitamin C intake from diet and supplements were collected through questionnaires. Concentrations of metals in participants' blood were measured using inductively coupled plasma-mass spectrometry (ICP-MS). Unconditional logistic regression models were applied to estimate effect modification of vitamin C on the association between heavy metals and GDM. Results: Women with higher blood levels of mercury (Hg) (odds ratio (OR) = 2.36, 95% confidence interval (CI): 1.43, 3.92 and 2.04, 95% CI: 1.20, 3.46 for the second and third vs. the first tertile) and arsenic (As) (OR = 2.46, 95% CI: 1.37, 4.43 and 2.16, 95% CI: 1.12, 4.17 for the second and third vs. the first tertile) exposure were associated with increased risk of GDM among women without vitamin C supplement use and having dietary vitamin C intake < 85 mg/day. We found no significant association with metals among women who took vitamin C supplements and/or dietary vitamin C ≥ 85 mg/day. Significant interactions were observed between vitamin C and exposures to metals (i.e., Hg and As) on the risk of GDM (P interaction = 0.048 and 0.045, respectively). Conclusions: Our study, for the first time, suggests that vitamin C supplement use or higher dietary vitamin C intake during preconception and early pregnancy could alleviate the risk of GDM associated with exposure to As and Hg. The results warrant further investigation.

Decellularized, Heparinized Small-Caliber Tissue-Engineered "Biological Tubes" for Allograft Vascular Grafts.

There remains a lack of small-caliber tissue-engineered blood vessels (TEBVs) with wide clinical use. Biotubes were developed by electrospinning and in-body tissue architecture (iBTA) technology to prepare small-caliber TEBVs with promising applications. Different ratios of hybrid fibers of poly(l-lactic-co-ε-caprolactone) (PLCL) and polyurethane (PU) were obtained by electrospinning, and the electrospun tubes were then implanted subcutaneously in the abdominal area of a rabbit (as an in vivo bioreactor). The biotubes were harvested after 4 weeks. They were then decellularized and cross-linked with heparin. PLCL/PU electrospun vascular tubes, decellularized biotubes (D-biotubes), and heparinized combined decellularized biotubes (H + D-biotubes) underwent carotid artery allograft transplantation in a rabbit model. Vascular ultrasound follow-up and histological observation revealed that the biotubes developed based on electrospinning and iBTA technology, after decellularization and heparinization cross-linking, showed a better patency rate, adequate mechanical properties, and remodeling ability in the rabbit model. IBTA technology caused a higher patency, and the heparinization cross-linking process gave the biotubes stronger mechanical properties.