MYC translocation is a valuable marker for the development and relapse of extramedullary disease in multiple myeloma.

OBJECTIVE: To study the cytogenetic characteristics of extramedullary disease (EMD) in patients with multiple myeloma (MM) and their impact on prognosis. METHODS: Patients with newly diagnosed MM (NDMM) at Peking Union Medical College Hospital (Beijing, China) between June 2007 and December 2019 were recruited for this study. Demographic information, clinical data, fluorescence in situ hybridization (FISH) results of marrow and tissue samples, and survival outcome data were collected. RESULTS: A total of 439 patients with NDMM were divided into those without EMD (non-EMD, n = 339), those with EMD with primary paraosseous plasmacytoma (pEMD-B, n = 48), those with primary EMD with soft-tissue involvement (pEMD-S, n = 33), and those with secondary EMD (sEMD, n = 19). The incidence of EMD was 18.5% (81/439) at diagnosis and 22.8% (100/439) throughout the disease course. Comparison of FISH results showed a higher proportion of RB1 deletion (n = 20; 60.0% vs. 20.0%, p = .013) and MYC translocation (n = 12; 44.4% vs. 12.5%, p = .041) in the extramedullary tissues than in the paired bone marrow samples. At diagnosis, the percentage of MYC translocations in the sEMD group was notably higher than that in the non-EMD group (55.6% vs. 15.5%, p = .012). The median overall survival (OS) of patients with pEMD-S (32 months) and sEMD (17 months) was significantly shorter (both p = .001) than that of non-EMD patients (60 months). CONCLUSION: Soft-tissue EMD can be considered a high-risk condition, even in the era of novel agents. MYC translocation can serve as a valuable marker that correlates with extramedullary spread and relapse in patients with MM and should be considered for inclusion in routine FISH panels in clinical practice.

Validation of Chinese version of the 5-item WHO well-being index in type 2 diabetes mellitus patients.

BACKGROUND: For better disease management and improved prognosis, early identification of co-morbid depression in diabetic patients is warranted. the WHO-5 well-being index (WHO-5) has been used to screen for depression in diabetic patients, and its Chinese version (WHO-5-C) has been validated. However, its psychometric properties remain to be further validated in the type 2 diabetes patient population. The aim of our study was to examine the reliability and validity of the WHO-5-C in patients with type 2 diabetes mellitus. METHODS: The cross-sectional study was conducted on 200 patients from July 2014 to March 2015. All patients should complete the WHO-5-C, the Patient Health Questionnaire-9 (PHQ-9), the 20-item Problem Areas in Diabetes Scale (PAID-20), the Mini International Neuropsychiatric Interview (M.I.N.I), and Hamilton Rating Scale for Depression (HAM-D). Internal consistency of WHO-5 was revealed by Cronbach's alpha, and constructive validity by confirmatory factor analysis (CFA). Relationship with PHQ-9, HAM-D, and PAID-20 was examined for concurrent validity, and ROC analysis was performed for criterion validity. RESULTS: The WHO-5-C presented satisfactory reliability (Cronbach's alpha = 0.88). CFA confirmed the unidimensional factor structure of WHO-5-C. The WHO-5-C had significant negative correlation with HAM-D (r = -0.610), PHQ-9 (r = -0.694) and PAID-20 (r = -0.466), confirming good concurrent validity. Using M.I.N.I as the gold standard, the cut-off value of WHO-5-C was 42, with a sensitivity of 0.83 and specificity of 0.75. CONCLUSION: The WHO-5-C holds satisfactory reliability and validity that is suitable for depression screening in type 2 diabetes patients as a short and convenient instrument.

The validity and IRT psychometric analysis of Chinese version of Difficult Doctor-Patient Relationship Questionnaire (DDPRQ-10).

OBJECTIVE: The doctor-patient relationship (DPR) plays a crucial role in the Chinese healthcare system, functioning to improve medical quality and reduce medical costs. This study examined the psychometric properties of the Chinese version of the Difficult Doctor-Patient Relationship Questionnaire (DDPRQ-10) among general hospital inpatients in China. METHODS: The research recruited 38 resident doctors responsible for 120 participants, and factor analyses were used to assess the construct validity of the scale. Convergent validity was evaluated by examining the correlation between DDPRQ-10 and depressive symptoms, burnout, and self-efficacy, using the Patient Health Questionnaire Depression Scale-9 item (PHQ-9), and the Maslach Burnout Inventory (MBI). Both multidimensional item response theory (MIRT) and unidimensional item response theory (IRT) frameworks were used to estimate the parameters of each item. RESULTS: The Chinese version of DDPRQ-10 showed satisfactory internal consistency (Cronbach's alpha = 0.931), and fitted in a modified two-factor model of positive feelings and negative feelings (χ2/df = 1.494, GFI = 0.925, RMSEA = 0.071, SRMR = 0.008, CFI = 0.985, NFI = 0.958, NNFI = 0.980, TLI = 0.980, IFI = 0.986). Significant correlations with PHQ-9 with DDPRQ-10 and both subscales were revealed (r = 0.293 ~ 0.333, p < .001), while DDPRQ-10 score also significantly correlated with doctors' MBI score (r = -0.467, p < .001). The MIRT model of full scale and IRT models of both subscales showed high discrimination of all items (a = 2.30 ~ 10.18), and the test information within the range of low-quality relationship was relatively high. CONCLUSION: The Chinese version of DDPRQ-10 displayed satisfactory reliability and validity and thus was appropriate for measuring the DPR in Chinese medical settings.

Structure and Physical Properties of the Layered Titanium-Based Pnictide Oxides (EuF)2Ti2Pn2O (Pn = Sb, Bi).

We report two novel titanium-based pnictide oxide compounds (EuF)2Ti2Pn2O (Pn = Sb, Bi), which are synthesized by replacing Sr2+ in (SrF)2Ti2Pn2O [Liu, R. H. Structure and Physical Properties of the Layered Pnictide-Oxides: (SrF)2Ti2Pn2O (Pn = As, Sb) and (SmO)2Ti2Sb2O. Chem. Mater. 2010, 22, 1503-1508] with Eu2+ using a solid-state reaction. (EuF)2Ti2Sb2O exhibits an obvious anomaly in resistivity and heat capacity at T ∼ 195 K, which may arise from the spin-density wave/charge-density wave instability. Similar features are also observed in BaTi2Pn2O, (SrF)2Ti2Pn2O, and Na2Ti2Pn2O (Pn = As and Sb) [Liu, R. H. Structure and Physical Properties of the Layered Pnictide-Oxides: (SrF)2Ti2Pn2O (Pn = As, Sb) and (SmO)2Ti2Sb2O. Chem. Mater. 2010, 22, 1503-1508, Ozawa, T. C. Chemistry of layered d-metal pnictide oxides and their potential as candidates for new superconductors. Sci. Technol. Adv. Mater. 2008, 9, 033003, Wang, X. F. Structure and physical properties for a new layered pnictide-oxide: BaTi2As2O. J. Phys.: Condens. Matter. 2010, 22, 075702, and Xu, H. C. Electronic structure of the BaTi2As2O parent compound of the titanium-based oxypnictide superconductor. Phys. Rev. B 2014, 89, 155108]. Magnetic susceptibility measurements indicate an antiferromagnetic transition at T ∼ 2.5 K for (EuF)2Ti2Sb2O. In particular, the electronic specific heat coefficients of both (EuF)2Ti2Sb2O and (EuF)2Ti2Bi2O are significantly enhanced compared to those of (SrF)2Ti2Pn2O, Na2Ti2Pn2O, and BaTi2Pn2O,1,5,6 which may be due to a strong electron correlation effect in this system. Thus, (EuF)2Ti2Pn2O (Pn = Sb, Bi) may provide new platforms for studying density wave, magnetic ordering, and electron correlation effects.

The combination of C-Myc rearrangement and 1q21 gain is associated with poor prognosis in multiple myeloma.

The prognostic value of chromosomal 1q21 gain in newly diagnosed multiple myeloma (NDMM) remains controversial. Add-on Myc aberrations may further worsen the outcome. To investigate whether specific genes located at the 1q21 region, such as myeloid cell leukemia 1 (Mcl-1), are involved in NDMM progression, we examined bone marrow cytogenetic abnormalities in 153 patients with NDMM by fluorescence in situ hybridization. Their response to treatment and survival was also analyzed. C-Myc and Mcl-1 expressions in bone marrow samples were analyzed by RT-PCR. The expression of Mcl-1 was evaluated in bone marrow sections by immunohistochemistry. MM cell lines were transfected with Mcl-1 siRNA. 1q21 gain was present in 55/153 (35.9%) patients and strongly associated with Myc rearrangement (31/153, 20.3%, P = 0.004). A positive correlation was observed between Myc and Mcl-1 mRNA levels in bone marrow cells from 47 patients (r = 0.57, P < 0.001). The combination of 1q21 gain and Myc rearrangement was associated with poorer overall survival than Myc rearrangement alone (16.8 vs. 27.9 months, P = 0.077) or 1q21 gain alone (16.8 vs. 60.7 months, P < 0.01). High Mcl-1 protein expression in bone marrow plasma cells was associated with Myc rearrangement. Mcl-1 silencing by siRNA inhibited Myc protein expression in three myeloma cell lines. Treatment with the small-molecule Mcl-1 inhibitor, UMI-77, produced similar results. Overall, the combination of Myc rearrangement and 1q21 gain was associated with particularly poor prognosis in patients with MM. Furthermore, our data are consistent with Mcl-1-dependent Myc protein activation.

Environment-friendly dual-network hydrogel dust suppressant based on xanthan gum, polyvinyl alcohol and acrylic acid.

Hydrogen bonding interactions among poly vinyl alcohol (PVA), xanthan gum (XG) and acrylic acid (AA) molecules have been utilized to prepare an environment-friendly interpenetrating double-network hydrogel dust suppressant (PVA-XG-PAA/SDBS) with the aim of enhancing the poor mechanical performance of current hydrogel dust suppressants. A single factor test was used to determine the optimal formulation conditions for the PVA-XG-PAA/SDBS, and the viscosity, surface tension, compression strength, wind resistance, water retention and biodegradability of the samples were measured. The results showed that the hydrogel with optimal usage contained 1.5 g, 0.1 g, and 6 g of PVA, XG and AA, respectively and the optimal reaction temperature was 55 °C. Under the optimal conditions, the viscosity was 45 mPa s, the surface tension was 30 mN/m, the compression strength of the dust suppressant-solidified coal pillar reached 126 kPa, and the degradation rate at the 8th cycle (40 days) after being buried in soil was 34%. Compared with a conventional hydrogel dust suppressant, like poly acrylic acid (PAA), and the dust suppressant sodium dodecyl benzene sulfonate (SDBS), the PVA-XG-PAA/SDBS showed better water retention, wind erosion resistance, and dust-solidifying properties. On the basis of these remarkable properties, the PVA-XG-PAA/SDBS is applicable for dust prevention during coal mining, transport, and storage, which enhances the dust suppression efficiency obviously and has significant meaning to the sustainable development of the coal mining industry while protecting the environment.

Can virtual reality improve traditional anatomy education programmes? A mixed-methods study on the use of a 3D skull model.

BACKGROUND: Realistic, portable, and scalable lectures, cadaveric models, 2D atlases and computer simulations are being combined more frequently for teaching anatomy, which result in major increases in user satisfaction. However, although digital simulations may be more portable, interesting, or motivating than traditional teaching tools, whether they are superior in terms of student learning remain unclear. This paper presents a study in which the educational effectiveness of a virtual reality (VR) skull model is compared with that of cadaveric skulls and atlases. The aim of this study was to compare the results of teaching with VR to results of teaching with traditional teaching methods by administering objective questionnaires and perception surveys. METHODS: A mixed-methods study with 73 medical students was conducted with three different groups, namely, the VR group (N = 25), cadaver group (N = 25) and atlas group (N = 23). Anatomical structures were taught through an introductory lecture and model-based learning. All students completed the pre- and post-intervention tests, which comprised a theory test and an identification test. The theory test consisted of 18 multiple-choice questions, and the identification test consisted of 25 fill-in-the-blank questions. RESULTS: The participants in all three groups had significantly higher total scores on the post-intervention test than on the pre-intervention test; the post-intervention test score in the VR group was not statistically significantly higher than the post-intervention test score of the other groups (VR: 30 [IQR: 22-33.5], cadaver: 26 [IQR: 20-31.5], atlas: 28[IQR: 20-33]; p > 0.05). The participants in the VR and cadaver groups provided more positive feedback on their learning models than the atlas group (VR: 26 [IQR: 19-30], cadaver: 25 [IQR: 19.5-29.5], atlas: 12 [IQR: 9-20]; p < 0.001). CONCLUSIONS: The skull virtual learning resource (VLR) was equally efficient as the cadaver skull and atlas in teaching anatomy structures. Such a model can aid individuals in understanding complex anatomical structures with a higher level of motivation and tolerable adverse effects.

Effects of thermal treatments on the characterisation and utilisation of red mud with sawdust additive.

Extremely large amounts of red mud (bauxite residue) are generated globally every year from alumina refining industries, which are being disposed of on engineered landfills. The objective of this study is to investigate the effects of thermal treatments on red mud for development of utilisation strategies. Thermal treatments of red mud samples and their characterisations were investigated under inert (N2) and oxidative (air) conditions with and without sawdust addition at 200-600°C. After calcination, the resulting samples were analysed using thermogravimetric-infrared spectroscopy (TG-IR) for functional group transformations, thermogravimetric analysis (TGA) for thermal loss profiles and X-ray diffraction (XRD) for mineral transformations. The characterisation results showed that in N2 environment, boehmite in red mud was transferred to transition alumina at around 400°C while losing water from structural components. The addition of sawdust for incubation and calcination of red mud in air increased the surface area, whereas that in nitrogen atmosphere lead to reduction of hematite to magnetite at around 500°C. The incorporated carbon materials played a major role in increasing the surface area especially for pore size less than 2.5 nm. This treated red mud with altered mineral composition and improved properties for binding contaminants can be used for environmental remediation and in the process of metal recovery such as iron.

Prevention of taxi accidents in Xi'an, China: what matters most?

OBJECTIVES: Since the city of Xi'an has been extremely concerned with the serious problem of taxi involved crashes, injuries and fatalities, the primary purpose of this study is to identify the risk factors associated with the magnitude and nature of the problem and provide possible measures for enhancing the overall safety performance of taxi industry. METHODS: Using 726 crash samples from the original of 7,183 observations in Xi'an over the period from 2006 to 2012, comparative statistics and systematic analysis were employed to describe the distribution of taxi crashes by driver characteristics, roadway contributors and environmental factors and then determine the significant factors contributing to crash injuries and fatalities. RESULTS: The trend and pattern of taxi involved crashes vary significantly. Middle aged (77.27%) male (91.60%) drivers with limited education (68.59%) and less driving (31.27%) and job (82.50%) experience were much more likely to be involved in such a crash. Additionally, it is found that a large majority of taxi crashes occurred with the most frequent type of rear end collisions (30.72%), on six-lane segments without median (16.94%) or four legged intersections (15.29%), under adverse weather conditions (31.82%), at weekends (34.99%), and during winter days (34.72%), but fatal and serious crashes were more likely to happen at night (30.72%) or under wet road surface conditions (16.94%), due to driver's overspeeding, unbelted, disregarding signs or signals, or other types of risk driving behaviour. CONCLUSIONS: The risk of taxi related crashes varies by drivers, roadways and environment. To reduce the risk of potential crashes for taxi drivers, we recommend the targeted legislation and enforcement, stronger night and trip restrictions, awareness of risk behaviour, and periodical training requirement. Such proposals and measures are expected to help mitigate taxi crashes and promote road safety in China.

Integrating portable X-ray fluorescence site survey and ArcGIS models for rapid risk assessment and mitigation strategies at an abandoned arsenic mine site: a case study.

Australia's metalliferous abandoned mine sites (MAMSs), pose tangible threats to the environment and human health. To address these concerns, our study utilised state-of-the-art handheld XRF technology to conduct a real-time assessment of the Mole River arsenic mine site. The data revealed notably elevated levels of arsenic and manganese, with the southeast corner of the site identified as a contaminant hotspot. We used a tiered risk assessment approach to compare the detected contaminant concentrations to the Australian health investigation levels (tier 1). This led us to a broader examination of erosion vulnerabilities and the potential migration of contaminants (tier 2). Further, a hydrological assessment (tier 3) identified significant erosion in southern regions, indicating the potential for contaminants to be transported off-site through surface water runoff to Sam's Creek and Mole River. The proximity of a reservoir to these runoff pathways brought forth additional challenges, especially during heavy rainfall events. Subsequent laboratory analysis of water samples reinforced our findings, as they confirmed heightened arsenic concentrations in Mole River downstream, accentuating the potential risks to ecosystems and human health. By integrating the XRF contour map and erosion assessment with the RUSLE model, valuable insights are gained into critical hotspots with high contamination and erosion potential. By directing rehabilitation efforts towards critical hotspots, resources can be allocated more efficiently and cost-effectively.

Complete blood and urine paraprotein tests as response assessments in multiple myeloma patients treated with bortezomib, cyclophosphamide, and dexamethasone.

Background: This study assessed the effect of standardized efficacy markers on prognosis in patients with newly diagnosed multiple myeloma (MM) during the induction phase of treatment with bortezomib, cyclophosphamide, and dexamethasone (BCD). Methods: We retrospectively analyzed clinical data in 197 newly diagnosed MM patients treated with BCD as front-line regimen at Peking Union Medical College Hospital from January 1, 2013 to December 31, 2018. Results: There were 107 patients with International Staging System (ISS) III and 51 with paraprotein of light chain. Of these, 77 completed nine cycles of the BCD regimen. As the number of treatment cycles increased, the proportions of serum and urine immunofixation electrophoresis (IFE) tests elevated from 40.39% to 62.22% and 16.75% to 37.78%, respectively. More than 90% of intact immunoglobulin chain MM patients were evaluated for blood M protein per cycle, but that of urinary M protein was less than 60%. The detection rate of urinary M protein in light chain MM was more than 70% per cycle. Patients with a very good partial response (VGPR) had longer progression-free survival (PFS) than those with uncertain VGPR (32 vs. 26 months, p = 0.0336). Of the 141 patients who completed at least four cycles without undergoing autologous hematopoietic stem cell transplantation, those who were regularly assessed at every other cycle showed more favorable PFS than those who visited irregularly (27 vs. 22 months, p = 0.059). Conclusion: Urinary M protein detection rate is significantly lower than that in serum, leading to an overestimation of efficacy, premature reduction of treatment intensity, and shortened PFS. Precise response assessments are critical to treatment decisions and clinical diagnoses.

From growth to sustainability: investigating N-shaped EKC and the role of energy productivity, technological advancement, and human capital in OECD economies.

Environmental degradation rates have been on a concerning upward trajectory in recent decades, directly threatening the well-being of global populations. Responding to this urgent matter, scholars have been driven to explore its nuances, particularly emphasizing lowering energy consumption and carbon emissions amidst the growing demands of growing economies. Achieving the targets outlined in the 2015 Paris Climate Agreement has also become a priority for many countries. Therefore, this study scrutinizes the Environmental Kuznets Curve (EKC) hypothesis, specifically focusing on the role of energy productivity, technological advancement, and human capital in fostering a sustainable environment across 35 OECD economies from 1990 to 2018. Utilizing three robust econometric techniques, Cross-Sectional Autoregressive Distributed Lag (CS-ARDL), Fully Modified Ordinary Least Squares (FMOLS), and Dynamic Ordinary Least Squares (DOLS), we have drawn insightful conclusions from our data. The analysis substantiates an N-shaped EKC hypothesis relationship between GDP and CO2 emissions, pointing towards an initially increasing, then decreasing, and finally an increasing again trend of emissions with GDP. Furthermore, the long-term projections underscore that energy productivity, technological progression, and human capital formation harm the environment. These findings culminate in a call for governments to orchestrate extensive plans and initiatives. This involves promoting green technologies, renewable energy-based ideas, and comprehensive education and awareness programs. These efforts should span all educational levels, highlighting climate change, sustainable practices, and the need for CO2 reduction, empowering societies to contribute to a sustainable future.

The Chinese version of patient-doctor-relationship questionnaire (PDRQ-9): Factor structure, validation, and IRT psychometric analysis.

Objective: The patient-doctor relationship has been considered as a crucial concept in primary healthcare, while the medical reform launched by the Chinese government in 2009 has brought significant changes to the healthcare system, which made it urgent to introduce reliable measurement instruments for assessing today's doctor-patient relationship in China. This study examined the psychometric properties of the Chinese version of the Patient-Doctor-Relationship Questionnaire-9 item (PDRQ-9) scale among general hospital inpatients in China. Materials and methods: A total of 203 participants responded to the survey, of which 39 completed retest after 7 days. Factor analyses were used to test the construct validity of the scale. Convergent validity was evaluated by the correlation between PDRQ-9 and depressive symptoms measured using PHQ-9 (Patient Health Questionnaire Depression Scale-9 item). Both multidimensional item response theory (MIRT) and unidimensional item response theory (IRT) framework were used to estimate the parameters of each item. Results: The two-factor model of relationship quality and treatment quality was supported (χ2/df = 1.494, GFI = 0.925, RMSEA = 0.071, RMR = 0.008, CFI = 0.985, NFI = 0.958, NNFI = 0.980, TLI = 0.980, IFI = 0.986). The PDRQ-9 and both subscales showed significant correlation with PHQ-9 (r = -0.196∼-0.309) and good internal consistency (Cronbach's alpha = 0.865∼0.933). ANCOVA analysis adjusted with age revealed significant difference in PDRQ-9 ratings between patients with or without significant depressive symptoms (P = 0.019). The 7-day test-retest reliability of the scale was 0.730. The MIRT model of full scale and IRT models of both subscales showed high discrimination of all items (a = 2.46∼38.46), and the test information within the range of low-quality relationship was relatively high. Conclusion: The Chinese version of PDRQ-9 is a valid and reliable rating scale, which can measure the doctor-patient relationship among Chinese patients.

Improving Mechanical and Barrier Properties of Antibacterial Poly(Phenylene Sulfide) Nanocomposites Reinforced with Nano Zinc Oxide-Decorated Graphene.

Nano zinc oxide-decorated graphene (G-ZnO) was blended with polyphenylene sulfide (PPS) to improve its tensile, thermal, crystalline, and barrier properties. The properties of neat PPS and PPS/G-ZnO nanocomposites were characterized and compared using various tests, including tensile tests, scanning electron microscopy, X-ray diffraction, differential scanning calorimetry, thermogravimetric analysis, evaluation of Escherichia coli inhibition, and barrier performance. The results demonstrated that G-ZnO played a crucial role in heterogeneous nucleation and reinforcement. When the concentration of G-ZnO was 0.3%, the tensile strength, elongation at break, thermostability, crystallinity, and water vapor permeability coefficients (WVPC) approached their maximum values, and the microscopic morphology changed from the original brittle fracture to a relatively tough fracture. In addition, when G-ZnO was added to PPS at a ratio of 0.3%, the tensile strength, elongation at break, and WVPC of PPS were increased by 129%, 150%, and 283%, respectively, compared to pure PPS. G-ZnO endowed the nanocomposites with antibacterial properties. The improvement in barrier performance can be attributed to three reasons: (1) the presence of G-ZnO extended the penetration path of molecules; (2) the coordination and hydrogen bonds between PPS polymer matrix and G-ZnO nanofiller narrowed the H2O transmission path; and (3) due to its more hydrophobic surface, water molecules were less likely to enter the interior of PPS/G-ZnO nanocomposites. This study provides valuable insights for developing high-performance PPS-based nanocomposites for various applications.

Development and psychometric validation of the hospitalized patients' expectations for treatment scale-patient version.

Objectives: A general expectation measurement of inpatients across wards is needed in the patient safety management systems of general hospitals. This study developed and psychometrically validated a new scale fulfilling the requirements above: the Hospitalized Patients' Expectations for Treatment Scale-Patient version (HOPE-P). Methods: A total of 35 experts and ten inpatients were interviewed during the formulation of the HOPE-P scale, which was initially designed with three dimensions: doctor-patient communication expectations, treatment outcome expectations, and disease management expectancy. We recruited 210 inpatients from a general hospital in China and explored the reliability, validity, and psychometric characteristics of the questionnaire. Item analysis, construct validity, internal consistency and 7-day test-retest reliability analysis were applied. Results: Exploratory and confirmatory analyses supported a 2-dimension (doctor-patient communication expectation and treatment outcome expectation) structure with satisfactory model fit parameters (root mean square residual (RMR) = 0.035, a root-mean-square-error of approximation (RMSEA) = 0.072, comparative fit index (CFI) = 0.984, Tucker-Lewis index (TLI) = 0.970). Item analysis revealed an appropriate item design (r = 0.573-0.820). The scale exhibited good internal consistency, with Cronbach's α of 0.893, 0.761, and 0.919 for the overall scale, the doctor-patient communication expectation subscale, and the treatment outcome expectation subscale, respectively. The 7-day test-retest reliability was 0.782 (p < .001). Conclusion: Our results indicated that the HOPE-P is a reliable and valid assessment tool to measure the expectations of general hospital inpatients, with a strong capacity to recognize patients' expectations regarding doctor-patient communication and treatment outcomes.

A novel nomogram for the preoperative prediction of sentinel lymph node metastasis in breast cancer.

BACKGROUND OR PURPOSE: A practical noninvasive method to identify sentinel lymph node (SLN) status in breast cancer patients, who had a suspicious axillary lymph node (ALN) at ultrasound (US), but a negative clinical physical examination is needed. To predict SLN metastasis using a nomogram based on US and biopsy-based pathological features, this retrospective study investigated associations between clinicopathological features and SLN status. METHODS: Patients treated with SLN dissection at four centers were apportioned to training, internal, or external validation sets (n = 472, 175, and 81). Lymph node ultrasound and pathological characteristics were compared using chi-squared and t-tests. A nomogram predicting SLN metastasis was constructed using multivariate logistic regression models. RESULTS: In the training set, statistically significant factors associated with SLN+ were as follows: histology type (p < 0.001); progesterone receptor (PR: p = 0.003); Her-2 status (p = 0.049); and ALN-US shape (p = 0.034), corticomedullary demarcation (CMD: p < 0.001), and blood flow (p = 0.001). With multivariate analysis, five independent variables (histological type, PR status, ALN-US shape, CMD, and blood flow) were integrated into the nomogram (C-statistic 0.714 [95% CI: 0.688-0.740]) and validated internally (0.816 [95% CI: 0.784-0.849]) and externally (0.942 [95% CI: 0.918-0.966]), with good predictive accuracy and clinical applicability. CONCLUSION: This nomogram could be a direct and reliable tool for individual preoperative evaluation of SLN status, and therefore aids decisions concerning ALN dissection and adjuvant treatment.

EGFR regulation of colon cancer stem-like cells during aging and in response to the colonic carcinogen dimethylhydrazine.

One of the most consistent pathological conditions in the gastrointestinal tract with advancing age is malignancy, particularly gastrointestinal cancers, the incidence of which increases sharply with aging. Although the reasons for the age-related rise in colorectal cancer are not fully understood, we hypothesize that aging increases susceptibility of the colon to carcinogen(s)/toxicant(s), leading to an increase in cancer stem-like cells (CSLCs) that express cancer stem cell markers, in the colonic mucosa. The current study demonstrates that aging is associated with increased expression of several colon CSLC markers [CD44, CD166, and aldehyde dehydrogenase 1 (ALDH-1)] and a higher proportion of cells expressing these markers. Aging is also accompanied by increased expression of miR-21 in colon. These increases are further increased in response to the colonic carcinogen dimethylhydrazine (DMH). Aging is also associated with increased tyrosine-phosphorylated epidermal growth factor receptor (EGFR). Inhibition of EGFR using the EGFR inhibitor cetuximab abrogated the age-related increase in CD166 and ALDH-1 as well as miRNA (miR)-21. Our results provide new evidence that aging and DMH are associated with increases in CSLC biomarkers and miR21, each of which have been linked to colorectal cancer. EGFR inhibition attenuates these changes, indicating a role for EGFR in age- and mutagen-associated changes in CSLCs.

Magnetic responsive mesoporous alginate/ß-cyclodextrin polymer beads enhance selectivity and adsorption of heavy metal ions.

Mesoporous (~7-8 nm) biopolymer hydrogel beads (HNTs-FeNPs@Alg/ß-CD) were synthesised via ionic polymerisation route to separate heavy metal ions. The adsorption capacity of HNTs-FeNPs@Alg/ß-CD was higher than that of raw halloysite nano tubes (HNTs), iron nanoparticles (FeNPs), and bare alginate beads. FeNPs induce the magnetic properties of adsorbent and metal-based functional groups in and around the hydrogel beads. The mesoporous surface of the adsorbent permits access of heavy metal ions onto the polymer beads to interact with internal active sites and the mesoporous polymer network. Maximum adsorption capacities of lead (Pb), copper (Cu), cadmium (Cd), and nickel (Ni) were 21.09 mg/g, 15.54 mg/g, 2.47 mg/g, and 2.68 mg/g, respectively. HNTs-FeNPs@Alg/ß-CD was able to adsorb heavy metals efficiently (75-99%) under environment-relevant concentrations (200 µg/L) from mixed metal contaminants. The adsorption and selectivity trends of heavy metals were Pb > Cu > Cd > Ni, despite electrostatic binding strength of Cd > Cu > Pb > Ni and covalent binding strength of Pb > Ni > Cu > Cd. It demonstrated that not only chemosorption but also physisorption acts as the sorption mechanism. The reduction in surface area, porosity, and pore volume of the expended adsorbent, along with sorption study results, confirmed that pore filling and intra-particle diffusion played a considerable role in removing heavy metals.

Effects of chelates (EDTA, EDDS, NTA) on phytoavailability of heavy metals (As, Cd, Cu, Pb, Zn) using ryegrass (Lolium multiflorum Lam.).

This paper summarises a study of the application of the synthetic chelate ethylenediaminetetraacetic acid (EDTA), and the natural chelates ethylenediamine-N,N'-disuccinic acid (EDDS) and nitrilotriacetate (NTA) to enhance ryegrass (Lolium multiflorum Lam.) uptake of the heavy metal(oid)s (HMs) (As, Cd, Cu, Pb and Zn) from contaminated soils in mining sites. The study compares the effects of these chelates (EDTA, EDDS and NTA) on the phytoavailability of HMs (As, Cd, Cu, Pb, Zn) using ryegrass (Lolium multiflorum Lam.) through the single addition and sequential addition methods. The results show that application of EDTA, EDDS and NTA significantly increases ryegrass (Lolium multiflorum Lam.)'s shoot uptake of some HMs when compared with no EDTA, EDDS or NTA application, particularly through sequential chelate treatment (EDTA 0.5:1+0.5:1; NTA 0.5:1+0.5:1; EDDS 0.5:1+0.5:1). EDTA 0.5:1+0.5:1 was more effective at increasing the concentration of Pb in shoots than were the other chelates (EDDS and NTA) and controls. Moreover, the concentrations of Zn in the shoots of ryegrass (Lolium multiflorum Lam.) in Hich Village significantly increased with the application of split dose (0.5:1+0.5:1). The plants displayed symptoms of toxicity including yellow and necrotic leaves at the end of the experiment. The selected chelates (EDTA, EDDS and NTA) led to a significant decrease in plant biomass (yield) 28 days after transfer with a maximum decrease in EDTA treatment (0.5:1+0.5:1) soils. This decrease was 3.43-fold in Ha Thuong, 3-fold in Hich Village and 1.59-fold in Trai Cau, respectively, relative to the control. HM concentration and dissolved organic carbon (DOC) in pore water provided an explanation for why fresh weight was significantly reduced with application of chelates in sequential dose (EDTA 0.5:1+0.5:1 and NTA 0.5:1+0.5:1).

Bacterial community profile of the crude oil-contaminated saline soil in the Yellow River Delta Natural Reserve, China.

Crude oil contamination greatly influence soil bacterial community. Proliferative microbes in the crude oil-contaminated soil are closely related to the living conditions. Oil wells in the Yellow River Delta Natural Reserve (YRDNR) region is an ideal site for investigating the bacterial community of crude oil-contaminated saline soil. In the present study, 18 soil samples were collected from the depths of 0-20 cm and 20-40 cm around the oil wells in the YRDNR. The bacterial community profile was analyzed through high-throughput sequencing to trace the oil-degrading aerobic and anaerobic bacteria. The results indicated that C15-C28 and C29-C38 were the main fractions of total petroleum hydrocarbon (TPH) in the sampled soil. These TPH fractions had a significant negative effect on bacterial biodiversity (Shannon, Simpson, and Chao1 indices), which led to the proliferation of hydrocarbon-degrading bacteria. A comprehensive analysis between the environmental factors and soil microbial community structure showed that Streptococcus, Bacillus, Sphingomonas, and Arthrobacter were the aerobic hydrocarbon-degrading bacteria; unidentified Rhodobacteraceae and Porticoccus were considered to be the possible facultative anaerobic bacteria with hydrocarbon biodegradation ability; Acidithiobacillus, SAR324 clade, and Nitrosarchaeum were predicted to be the anaerobic hydrocarbon-degrading bacteria in the sub-surface soil. Furthermore, large amount of carbon sources derived from TPH was found to cause depletion of bioavailable nitrogen in the soil. The bacteria associated with nitrogen transformation, such as Solirubrobacter, Candidatus Udaeobacter, Lysinibacillus, Bradyrhizobium, Sphingomonas, Mycobacterium, and Acidithiobacillus, were highly abundant; these bacteria may possess the ability to increase nitrogen availability in the crude oil-contaminated soil. The bacterial community functions were significantly different between the surface and the sub-surface soil, and the dissolved oxygen concentration in soil was considered to be potential influencing factor. Our results could provide useful information for the bioremediation of crude oil-contaminated saline soil.