Risk of COVID-19 infection in patients with NSCLC receiving EGFR-TKI targeted therapy during the first wave in China.

OBJECTIVE: We examined the factors influencing hospitalization and prognosis among patients with non-small cell lung cancer receiving epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) targeted therapy during the first wave of the coronavirus disease 2019 (COVID-19) pandemic. METHODS: In total, 267 patients diagnosed with NSCLC who were receiving treatment with third-generation EGFR-TKIs were included in our retrospective study. Data on patients' demographics, clinical characteristics, and survival were collected and analyzed. RESULTS: Over a mean follow-up of 18 months, 80.5% (215/267) of the patients contracted COVID-19, and 12.6% (27/215) of these patients were hospitalized for COVID-19 treatment. Vaccinated patients, those with body mass index (BMI) ≥22.3 kg/m2, and those with no comorbidities had lower rates of infection and hospitalization than unvaccinated patients, those with BMI <22.3 kg/m2, and those with comorbidities, respectively. Continued NSCLC treatment in patients with COVID-19 was identified as a risk factor for patient survival. CONCLUSIONS: NSCLC treatment can be continued for patients who received COVID-19 vaccines, those with higher BMI, and those without comorbidities during the COVID-19 epidemic, but treatment interruption might be required for patients during the active phase of infection.

The Effects of Abnormal Exposure on Individual Dose Monitoring with TLD Dosimeters.

ABSTRACT: Objectives: To analyze the effects of normal x-ray inspection, machine washing, and machine drying on thermoluminescent dosimeter (TLD) measurements during external individual monitoring and to provide suggestions for determining individual monitoring measurements under the mentioned abnormal situations. In this study, we focused on three abnormal situations: x-ray inspection, machine washing, and machine drying, which are common in external individual dose monitoring. We measured and compared the doses from TLD with and without 11, 23, 35, and 50 security checks. We used different radiation sources to expose the TLDs before or after machine washing with or without hot drying. The three radiation sources are natural background radiation, 137 Cs γ rays, and 320 kVp x-rays. We measured 20 TLDs for each situation. The average doses for the TLDs with 11, 23, 35, 50 security checks are 27.7 µGy, 59.7 µGy, 84.1 µGy, and 121.0 µGy, respectively. We measured an average dose of 2.5 µGy per exposure. The doses showed no significant difference between different times of washing with different radiation sources, natural background radiation, 137 Cs, or x-ray exposures. There was also no significant difference between the dose coming from the controlled group, drying at 60 °C and 90 °C for 1 h after exposure to 137 Cs γ rays and 320 kVp x-rays. The common machine drying under the temperature of 90 °C did not affect TLD measured doses.

CD52 knockdown inhibits aerobic glycolysis and malignant behavior of NSCLC cells through AKT signaling pathway.

CD52 is an important functional regulator involved in the development of human cancer. In this study, the clinical significance and biological function of CD52 in the malignant behavior of non-small cell lung cancer (NSCLC) were explored. In this study, immunohistochemical (IHC) staining was performed to determine the expression pattern of CD52 in NSCLC. Loss of function assays were used to evaluate the biological functions of CD52 in NSCLC cells in vitro and in vivo. Our data indicated that the expression of CD52 was significantly elevated in NSCLC and correlated with the patient prognosis. Functionally, downregulation of CD52 expression significantly suppressed the proliferation, migration, aerobic glycolysis and tumorigenesis of NSCLC cells. Moreover, CD52 regulated aerobic glycolysis of NSCLC cells through the AKT pathway. Furthermore, aerobic glycolysis induced by 2-DG inhibited the proliferation of NSCLC cells. In conclusion, CD52 knockdown inhibited aerobic glycolysis and malignant behavior of NSCLC cells through AKT signaling pathway, which may be employed in an alternative therapeutic target for NSCLC.

Fast prediction of patient-specific organ doses in brain CT scans using support vector regression algorithm.

Objectives. This study aims to develop a method for predicting patient-specific head organ doses by training a support vector regression (SVR) model based on radiomics features and graphics processing unit (GPU)-calculated reference doses.Methods. In this study, 237 patients who underwent brain CT scans were selected, and their CT data were transferred to an autosegmentation software to segment head regions of interest (ROIs). Subsequently, radiomics features were extracted from the CT data and ROIs, and the benchmark organ doses were computed using fast GPU-accelerated Monte Carlo (MC) simulations. The SVR organ dose prediction model was then trained using the radiomics features and benchmark doses. For the predicted organ doses, the relative root mean squared error (RRMSE), mean absolute percentage error (MAPE), and coefficient of determination (R2) were evaluated. The robustness of organ dose prediction was verified by changing the patient samples on the training and test sets randomly.Results. For all head organs, the maximal difference between the reference and predicted dose was less than 1 mGy. For the brain, the organ dose was predicted with an absolute error of 1.3%, and theR2reached up to 0.88. For the eyes and lens, the organ doses predicted by SVR achieved an RRMSE of less than 13%, the MAPE ranged from 4.5% to 5.5%, and theR2values were more than 0.7.Conclusions. Patient-specific head organ doses from CT examinations can be predicted within one second with high accuracy, speed, and robustness by training an SVR using radiomics features.

Does home and community-based services use reduce hospital utilization and hospital expenditure among disabled elders? Evidence from China.

Introduction: In the background of aging in place, home and community-based services (HCBS) have been playing an increasingly important role in long-term care (LTC) security systems. However, it is still uncertain whether and how HCBS use affects hospital utilization and the corresponding expenditures. Methods: Using data from the China Health and Retirement Longitudinal Survey (CHARLS) and the China City Statistical Yearbook, the instrumental variable (IV) approach is applied to identify the causal effects of HCBS use on hospital utilization and hospital expenditure among disabled elders. Results: We find that HCBS use significantly reduces the probability of being hospitalized, the times of hospitalization, and the length of inpatient stay, as well as the total, out-of-pocket and reimbursement inpatient expenditures, demonstrating not only the substitution impact of HCBS for hospital care but also the effectiveness of medical expenditure control in LTC security systems. Heterogeneity analysis shows that the impacts of HCBS use on hospital utilization and hospital expenditure concentrate on disabled elders who are younger, male, living in urban areas, or from higher-income households; both healthcare and spiritual consolation services have significant negative effects, while the anticipated effects of daily care service use are not supported. The possible mechanisms are the substitution of HCBS for hospital care and the improvements in both the physical and psychological health of disabled elders. However, the mechanism of adverse events decrease is not verified, which needs to be investigated further with more proxy variables. Conclusion: This study provides empirical evidence that HCBS use can not only reduce hospital utilization and hospital expenditure among disabled elders but also improve their physical and psychological health. Policy designs should emphasize the orientation of HCBS, ensure the fundamental and central position of HCBS in the formal care service system, pay more attention to the accessibility and affordability of HCBS for fragile groups, and diversify and optimize the development of the health service and the spiritual consolation service.

Health effects of long-term care insurance on spouses of disabled people: a quasi-experimental study.

BACKGROUND: It is still uncertain whether and how formal long-term care (LTC) systems affect the health status of family members. This paper examines the health effects of long-term care insurance (LTCI) on spouses of disabled people in China. METHODS: The data is from China Health and Retirement Longitudinal Survey (CHARLS), a longitudinal survey of a nationally representative sample of Chinese residents aged 45 or older and their spouses, and China City Statistical Yearbook. Exploiting the regional variation in the implementation of LTCI in the first round of pilot cities in China, a difference-in-difference (DID) strategy is applied to identify the causal effects of LTCI on the health status of spouses of disabled people. We carefully identify the causal effects by controlling for city-level covariates, testing common trends between the treatment and control groups, combining propensity score matching (PSM) with DID, selecting the second round of pilot cities as the control group, controlling for city fixed effects (FE) instead of individual FE, and evaluating selection bias from omitted observable and unobservable factors. RESULTS: The introduction of LTCI in China reduces the number of painful body parts and the self-reported health score significantly, indicating that spouses of disabled people get physical health benefits from LTCI coverage. However, the impact of LTCI on the depression index remains ambiguous and needs to be analyzed further. LTCI improves the physical health status of spouses of disabled individuals mainly through the time reallocation channel, while the impact of the consumption promotion channel has not been verified. Furthermore, the beneficial effects of LTCI on physical health are stronger for spouse caregivers and spouses with lower-level education and lower household income. CONCLUSION: These findings demonstrate that LTCI not only improves the health status of family caregivers by reducing their caregiving burden but also has beneficial health effects on non-caregiver family members. Policy designs of LTCI should emphasize the orientation of home and community-based care services (HCBS), which can not only satisfy the care preferences of disabled individuals, reduce the care burden on family caregivers, promote the health of all family members, but also prevent a large number of disabled individuals from choosing high-cost institutional care and reduce the financial burden of the LTCI Fund.

Elucidation of the Reinforcing Spleen Effect of Jujube Fruits Based on Metabolomics and Intestinal Flora Analysis.

Jujube (Ziziphus jujuba Mill.) fruit (JF) is widely consumed as food in Asian countries due to its potential effects for human health. As a traditional Chinese medicine, JF is often used to treat anorexia, fatigue and loose stools caused by spleen deficiency syndromes in China, but the mechanism underlying this effect has not been thoroughly elucidated. In this study, a rat model of spleen deficiency syndromes was adopted to investigate the therapeutic effect of JF extract and its possible mechanism by metabolomics analyses of plasma and urine as well as the intestinal flora analysis. The results showed that the changes in plasma and urine metabolites caused by spleen deficiency were reversed after administration of JF, and these changed endogenous metabolites were mainly involved in retinol metabolism, pentose and glucuronate interconversions, nicotinate and niacinamide metabolism pathways. The 16S rDNA sequencing results showed that JF could regulate intestinal flora imbalance caused by spleen deficiency. The covariance analysis of intestinal flora structure and metabolome indicated that Aerococcus may be a candidate strain for predicting and treating the metabolic pathways of spleen deficiency and related disorders. In summary, it can be revealed that spleen deficiency, which alters metabolic profiles and the intestinal flora, could be alleviated effectively by JF extract.

Isolation, structural characterization and bioactivities of polysaccharides from Laminaria japonica: A review.

Laminaria japonica is a familiar marine plant and is often used as food due to its abundant carbohydrates, vitamins and minerals. As one of the main types of active substances in L. japonica, polysaccharides are widely used in the food and chemical industries and in medicine and healthcare due to their health benefits, such as immunoregulatory, antioxidant, and antidiabetic effects. However, there has been no systematic summary of the isolation, structural characterization and bioactivities of L. japonica polysaccharides (LJPs). Therefore, the present review includes a survey of extraction and purification methods for these bioactive molecules, along with a dissertation on the structural characterization of the carbohydrate components. Moreover, an overview of the most recent results related to LJP biological activities is provided. This review provides a useful reference for further research, production, and application of LJPs in functional foods and therapeutic agents.

Synthesis of starch nanoparticles with controlled morphology and various adsorption rate for urea.

Starch nanoparticles (SNPs) with different morphology and particle size can be prepared by modulating the reaction conditions over SNPs preparation. This study was to synthesize various SNPs by using ultrasound assisted nanoprecipitation method, and characterized by particle size analysis, SEM and XRD performing. SNPs were successfully produced via nanoprecipitation and the particle size were controlled in the range of 95 to 150 nm. Moreover, variously different morphologies were obtained when using corn, potato or Trichosanthes kirilowii pulp (TKP) starch to produce nanoparticles, including fiber, flake and film. Results shown film TKP SNPs demonstrated an improved urea adsorption rate to 135.60 mg/g with the highest qm at 1.00 mg/mL. SNPs can be developed using ultrasound assisted nanoprecipitation method and the particle size together with surface morphology can be varied according to the source of starch and preparation method, while surface morphology is the key factor in altering adsorption performance.

Trends in radiation exposure from clinical nuclear medicine procedures in Shanghai, China.

OBJECTIVES: This study was designed to assess the trends in the frequencies of nuclear medicine procedures in Shanghai, China, and to determine their contributions to the per capita effective dose to the Shanghai population. The mean activities of radionuclides administered by nuclear medicine departments were compared with the Chinese national guidelines on diagnostic reference levels. METHODS: On the basis of the three surveys carried out by Shanghai Municipal Center for Disease Control and Prevention in 1996, 1998, and 2008, the typically administered radiopharmaceuticals, levels of activity, the number of procedures, and population were systematically analyzed to assess the frequencies of nuclear medicine procedures and the per capita effective dose. RESULTS: The frequencies were approximately 2.77, 3.46, and 6.63 per 1000 people in 1996, 1998, and 2008, respectively. The annual per capita doses from diagnostic nuclear medicine were estimated to be 0.016, 0.022, and 0.032 mSv in 1996, 1998, and 2008, respectively. The annual frequency of therapeutic nuclear medicine procedures increased from 0.131 to 0.430 per 1000 people in the intervening 12 years. CONCLUSION: In the 12 years before 2008, diagnostic and therapeutic procedures in nuclear medicine in Shanghai increased continuously, and the annual per capita dose doubled. Increases in PET imaging and bone scans were the major contributors to the increasing frequency and magnitude of radiation exposure to the population. The activities administered for most diagnostic procedures were generally consistent with the designated reference levels.

Patient doses in different projections of conventional diagnostic X-ray examinations.

The entrance surface doses (ESDs) of six commonly performed diagnostic X-ray projections were surveyed in four public hospitals, and an experimental formula was derived for estimating the ESD from the exposure parameters of different projections. In-phantom measurements of the organ doses were also performed for the six projections, and the effective doses were evaluated using different sets of tissue weighting factors recommended by the International Commission on Radiological Protection (ICRP). For the chest radiograph, compared with the low tube potential technique, lower ESD was observed in the high tube potential technique; however, no significant difference of effective doses was found between the two techniques. Except for the pelvis radiography, the effective doses of five other projections evaluated with the tissue weighting factors (w(T)) recommended by ICRP publication 103 were generally higher than those evaluated with the factors recommended by ICRP publication 60.

Cross-section measurements for (n, 2n) and (n, alpha) reactions on yttrium at neutron energies from 13.5 to 14.6 MeV.

The cross sections for the reactions (89)Y(n, 2n) (88m+g)Y and (89)Y(n, alpha) (86m+g)RB induced by 14MeV neutrons have been measured using the activation technique and a coaxial HPGe gamma-ray detector. Spectroscopically pure Y(2)O(3) powder was used. Fast neutrons were produced by the T(d, n) (4)He reaction. The neutron fluencies were determined using the monitor reaction (93)Nb(n, 2n) (92m)Nb.

Cross-section measurements for the reactions of 14 MeV neutrons on indium isotopes.

The cross sections for the reactions (115)In(n, p)(115g)Cd, (115)In(n, alpha)(112)Ag, (115)In(n, 2n)(114m)In, (113)In(n, 2n)(112m)In, (115)In(n, n')(115m)In, and (113)In(n, n')(113m)In induced by 14 MeV neutrons have been measured by activation relative to the (27)Al(n, alpha)(24)Na. Measurements were carried out by gamma-detection using a coaxial HPGe detector. As samples, natural indium has been used. The fast neutrons were produced by the T(d, n)(4)He reaction. The results obtained are compared with existing data.

Cross-section measurements for the 128Te(n,2n) 127mTe reaction induced by neutrons around 14 MeV.

The cross sections of 128Te(n,2n) 127mTe reaction induced by neutrons around 14 MeV were measured using activation technique and calculated by a previously developed formula. 737+/-69 and 853+/-82 mb at the neutron energies of 14.1+/-0.2 and 14.6+/-0.3 MeV, respectively; these are in good agreement with those published by other workers.