Hepatitis-related adverse events associated with immune checkpoint inhibitors in cancer patients: an observational, retrospective, pharmacovigilance study using the FAERS database.

Background: Immune checkpoint inhibitors (ICIs), including anti-PD-1, anti-PD-L1 and anti-CTLA-4 antibodies, have become a standard treatment for multiple cancer types. However, ICIs can induce immune-related adverse events, with hepatitis-related adverse events (HRAEs) being of particular concern. Our objective is to identify and characterize HRAEs that exhibit a significant association with ICIs using real-world data. Methods: In this observational and retrospective pharmacovigilance study, we extracted real-world adverse events reports from the FDA Adverse Event Reporting System database spanning from the first quarter of 2004 to the first quarter of 2023. We conducted both Frequentist and Bayesian methodologies in the framework of disproportionality analysis, which included the reporting odds ratios (ROR) and information components (IC) to explore the intricate relationship between ICIs and HRAEs. Results: Through disproportionality analysis, we identified three categories of HRAEs as being significantly related with ICIs, including autoimmune hepatitis (634 cases, ROR 19.34 [95% CI 17.80-21.02]; IC025 2.43), immune-mediated hepatitis (546 cases, ROR 217.24 [189.95-248.45]; IC025 4.75), and hepatitis fulminant (80 cases, ROR 4.56 [3.65-5.70]; IC025 0.49). The median age of patients who report ICI-related HRAEs was 63 years (interquartile range [IQR] 53.8-72), with a fatal outcome observed in 24.9% (313/1,260) of these reports. Cases pertaining to skin cancer, lung cancer, and kidney cancer constituted the majority of these occurrences. Patients treated with anti-PD-1 or anti-PD-L1 antibodies exhibited a higher frequency of immune-mediated hepatitis in comparison to those undergoing anti-CTLA-4 monotherapy, with a ROR of 3.59 (95% CI 1.78-6.18). Moreover, the dual ICI therapy demonstrated higher reporting rates of ICI-related HRAEs compared to ICI monotherapy. Conclusion: Our findings confirm that ICI treatment carries a significant risk of severe HRAEs, in particular autoimmune hepatitis, immune-mediated hepatitis, and hepatitis fulminant. Healthcare providers should exercise heightened vigilance regarding these risks when managing patients receiving ICIs.

Pulmonary haemorrhage and haemoptysis associated with bevacizumab-related treatment regimens: a retrospective, pharmacovigilance study using the FAERS database.

Background: Bevacizumab (BV) is widely used in routine cancer treatment and clinical therapy in combination with many other agents. This study aims to describe and analyse post-market cases of pulmonary haemorrhage and haemoptysis reported with different BV treatment regimens by mining data from the United States Food and Drug Administration Adverse Event Reporting System (FAERS) database. Methods: Data were collected from the FAERS database between 2004 Q1 and 2023 Q1. Disproportionality analysis including the reporting odds ratio (ROR) was employed to quantify the signals of disproportionate reporting of pulmonary haemorrhage and haemoptysis adverse events (AEs) associated with BV-related treatment regimens. The demographic characteristics, time to onset and outcomes were further clarified. Results: A total of 55,184 BV-associated reports were extracted from the FAERS database, of which 497 reports related to pulmonary haemorrhage and haemoptysis. Overall, the median onset time of pulmonary haemorrhage and haemoptysis AEs was 43 days (interquartile range (IQR) 15-117 days). In the subgroup analysis, BV plus targeted therapy had the longest median onset time of 90.5 days (IQR 34-178.5 days), while BV plus chemotherapy had the shortest of 40.5 days (IQR 14-90.25). BV plus chemotherapy disproportionately reported the highest percentage of death (148 deaths out of 292 cases, 50.68%). Moreover, the BV-related treatments including four subgroups in our study demonstrated the positive signals with the association of disproportionate reporting of pulmonary haemorrhage and haemoptysis. Notably, BV plus chemotherapy showed a significant higher reporting risk in pulmonary haemorrhage and haemoptysis signals of disproportionate reporting in comparison to BV monotherapy (ROR 5.35 [95% CI, 4.78-6.02] vs. ROR 4.19 [95% CI, 3.56-4.91], p = 0.0147). Conclusion: This study characterized the reporting of pulmonary haemorrhage and haemoptysis, along with the time to onset and demographic characteristics among different BV-related treatment options. It could provide valuable evidence for further studies and clinical practice of BV.

Opioid Nonadherence Risk Prediction of Patients with Cancer-Related Pain Based on Five Machine Learning Algorithms.

Objectives: Opioid nonadherence represents a significant barrier to cancer pain treatment efficacy. However, there is currently no effective prediction method for opioid adherence in patients with cancer pain. We aimed to develop and validate a machine learning (ML) model and evaluate its feasibility to predict opioid nonadherence in patients with cancer pain. Methods: This was a secondary analysis from a cross-sectional study that included 1195 patients from March 1, 2018, to October 31, 2019. Five ML algorithms, such as logistic regression (LR), random forest, eXtreme Gradient Boosting, multilayer perceptron, and support vector machine, were used to predict opioid nonadherence in patients with cancer pain using 43 demographic and clinical factors as predictors. The predictive effects of the models were compared by the area under the receiver operating characteristic curve (AUC_ROC), accuracy, precision, sensitivity, specificity, and F1 scores. The value of the best model for clinical application was assessed using decision curve analysis (DCA). Results: The best model obtained in this study, the LR model, had an AUC_ROC of 0.82, accuracy of 0.82, and specificity of 0.71. The DCA showed that clinical interventions for patients at high risk of opioid nonadherence based on the LR model can benefit patients. The strongest predictors for adherence were, in order of importance, beliefs about medicines questionnaire (BMQ)-harm, time since the start of opioid, and BMQ-necessity. Discussion. ML algorithms can be used as an effective means of predicting adherence to opioids in patients with cancer pain, which allows for proactive clinical intervention to optimize cancer pain management. This trial is registered with ChiCTR2000033576.

Enhanced Interface Charge Carrier Transport of SnO2/CeO2 via Oxygen Vacancy Synergized Heterojunction for Triethylamine Sensing Property.

Efficient charge carrier transport characteristics are critical to achieving the excellent performance of metal-oxide semiconductor gas sensors. Herein, SnO2/CeO2 heterojunction layered nanosheets with abundant oxygen vacancies were successfully synthesized through a simple solvothermal assisted high-temperature calcination method. The synergistic effect of oxygen vacancies and heterojunctions promoting the charge carrier transport properties at the SnO2/CeO2 interface for the enhanced sensing properties of triethylamine (TEA) was highlighted. As a result, the optimized SnO2/CeO2 exhibits improved gas sensing performance at 173 °C to 50 ppm of TEA. These include high response (205), excellent selectivity, low detection limit, and good long-term stability. This enhanced gas sensing property of SnO2/CeO2 is mainly attributed to the fact that the heterojunction and oxygen vacancies act as dual active sites synergistically inducing electron transfer, thereby effectively modulating the transport properties of the interfacial charge carriers, and thus facilitate the surface reactions efficiently. In this work, the dual-engineering strategy of synergistic interaction of heterojunction and oxygen vacancies can provide new perspectives for the design of advanced gas sensing materials.

The regulation and its application of the charge decay rate in triboelectric nanogenerator.

The decay rate of charge in the friction layer is one of the key factors affecting the output performance of triboelectric nanogenerators (TENG). Reducing the decay rate of the triboelectric charge can increase the charge-carrying capacity of the friction layer and improve the output current and voltage of the TENG. This makes a friction generator more suitable for discontinuous driving environments. In contrast, increasing the decay rate of the charge in the friction layer can greatly improve the recovery time of the device, although it reduces the output performance of the generator. This is conducive to the application of friction generator in the field of sensors. In this study, polystyrene (PS) and carbon nanotubes (CNTs) were added to polyvinylidene fluoride (PVDF) nanofibers to adjust the charge decay time in the friction layer, thereby regulating the output performance of the friction generator and sensor. When the amount of added PS in the PVDF nanofiber reached 20%, the charge density on the friction surface increased by 1.9 times, and the charge decay time decreased by 64 times; when 0.1 wt% CNTs were added in the PVDF nanofiber, the charge decay time increased by more than 10 times. The former is more conducive to improving the power generation performance of the TENG, and the latter significantly improves the stability and repeatability of TENG-based sensors.

RANBP17 Overexpression Restores Nucleocytoplasmic Transport and Ameliorates Neurodevelopment in Induced DYT1 Dystonia Motor Neurons.

DYT1 dystonia is a debilitating neurological movement disorder, and it represents the most frequent and severe form of hereditary primary dystonia. There is currently no cure for this disease due to its unclear pathogenesis. In our previous study utilizing patient-specific motor neurons (MNs), we identified distinct cellular deficits associated with the disease, including a deformed nucleus, disrupted neurodevelopment, and compromised nucleocytoplasmic transport (NCT) functions. However, the precise molecular mechanisms underlying these cellular impairments have remained elusive. In this study, we revealed the genome-wide changes in gene expression in DYT1 MNs through transcriptomic analysis. We found that those dysregulated genes are intricately involved in neurodevelopment and various biological processes. Interestingly, we identified that the expression level of RANBP17, a RAN-binding protein crucial for NCT regulation, exhibited a significant reduction in DYT1 MNs. By manipulating RANBP17 expression, we further demonstrated that RANBP17 plays an important role in facilitating the nuclear transport of both protein and transcript cargos in induced human neurons. Excitingly, the overexpression of RANBP17 emerged as a substantial mitigating factor, effectively restoring impaired NCT activity and rescuing neurodevelopmental deficits observed in DYT1 MNs. These findings shed light on the intricate molecular underpinnings of impaired NCT in DYT1 neurons and provide novel insights into the pathophysiology of DYT1 dystonia, potentially leading to the development of innovative treatment strategies.

Laparoscopic continuous seromuscular circumsuture for myomectomy: a real-world, retrospective, East-Asian cohort study.

OBJECTIVE: This study aimed to introduce a novel laparoscopic haemostasis for myomectomy and investigate the independent risk factors for uterine fibroid recurrence. DESIGN: A retrospective cohort study. SETTING: Following strengthening the reporting of observational studies in epidemiology (STROBE) criteria, a retrospective study of prospectively collected available data of the consecutive patients who underwent the myomectomy in the department of obstetrics and gynaecology of the single centre between February 2018 and December 2020. PARTICIPANTS: 177 patients who underwent laparoscopic myomectomy resection were enrolled in the present cohort study. MATERIALS AND METHODS: Patients were classified into two groups according to their different methods of haemostasis in laparoscopic surgery. Recurrence-free survival was compared between the groups during an average follow-up of nearly 2 years. RESULTS: Of the 177 patients from 672 consecutive patients in the retrospective cohort, laparoscopic circular suture and baseball suture were carried out in 102 (57.6%) and 75 (42.4%) patients, respectively. The total amount of blood lost during surgery varied significantly (37.6 vs 99.5 mL) (p<0.001). Univariable analyses identified that age ≥40 years, position at intramural myoma, multiple fibroids and largest fibroid volume ≥50 mm3 (HR 2.222, 95% CI 1.376 to 3.977, p=0.039; HR 3.625, 95% CI 1.526 to 6.985, p=0.003; HR 3.139, 95% CI 1.651 to 5.968, p<0.001; HR 2.328, 95% CI 0.869 to 3.244, p=0.040, respectively) are independent risk factor of the recurrence of uterine fibroids. The formula of the nomogram prediction model was established as the practical clinical tool. CONCLUSION: The laparoscopic continuous seromuscular circumsuture for myomectomy can effectively reduce the amount of surgical bleeding and accelerate the perioperative recovery for surgical safety. The main factors affecting the recurrence of uterine fibroids were age, location, number and volume of uterine fibroids. The nomogram can more straightforwardly assist clinicians to determine the risk of recurrence after laparoscopic myomectomy.

Pigment Diversity in Leaves of Caladium × hortulanum Birdsey and Transcriptomic and Metabolic Comparisons between Red and White Leaves.

Leaf color is a key ornamental characteristic of cultivated caladium (Caladium × hortulanum Birdsey), a plant with diverse leaf colors. However, the genetic improvement of leaf color in cultivated caladium is hindered by the limited understanding of leaf color diversity and regulation. In this study, the chlorophyll and anthocyanin content of 137 germplasm resources were measured to explore the diversity and mechanism of leaf color formation in cultivated caladium. Association analysis of EST-SSR markers and pigment traits was performed, as well as metabolomics and transcriptomics analysis of a red leaf variety and its white leaf mutant. We found significant differences in chlorophyll and anthocyanin content among different color groups of cultivated caladium, and identified three, eight, three, and seven EST-SSR loci significantly associated with chlorophyll-a, chlorophyll-b, total chlorophyll and total anthocyanins content, respectively. The results further revealed that the white leaf mutation was caused by the down-regulation of various anthocyanins (such as cyanidin-3-O-rutinoside, quercetin-3-O-glucoside, and others). This change in concentration is likely due to the down-regulation of key genes (four PAL, four CHS, six CHI, eight F3H, one F3'H, one FLS, one LAR, four DFR, one ANS and two UFGT) involved in anthocyanin biosynthesis. Concurrently, the up-regulation of certain genes (one FLS and one LAR) that divert the anthocyanin precursors to other pathways was noted. Additionally, a significant change in the expression of numerous transcription factors (12 NAC, 12 bZIP, 23 ERF, 23 bHLH, 19 MYB_related, etc.) was observed. These results revealed the genetic and metabolic basis of leaf color diversity and change in cultivated caladium, and provided valuable information for molecular marker-assisted selection and breeding of leaf color in this ornamental plant.

Lipocalin 2 (LCN2) confers acquired resistance to almonertinib in NSCLC through LCN2-MMP-9 signaling pathway.

Almonertinib, a third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, is highly selective for EGFR-activating mutations as well as the EGFR T790M mutation in patients with advanced non-small cell lung cancer (NSCLC). However, the development of resistance inevitably occurs and poses a major obstacle to the clinical efficacy of almonertinib. Therefore, a clear understanding of the mechanism is of great significance to overcome drug resistance to almonertinib in the future. In this study, NCI-H1975 cell lines resistant to almonertinib (NCI-H1975 AR) were developed by concentration-increasing induction and were employed for clarification of underlying mechanisms of acquired resistance. Through RNA-seq analysis, the HIF-1 and TGF-ß signaling pathways were significantly enriched by gene set enrichment analysis. Lipocalin-2 (LCN2), as the core node in these two signaling pathways, were found to be positively correlated to almonertinib-resistance in NSCLC cells. The function of LCN2 in the drug resistance of almonertinib was investigated through knockdown and overexpression assays in vitro and in vivo. Moreover, matrix metalloproteinases-9 (MMP-9) was further identified as a critical downstream effector of LCN2 signaling, which is regulated via the LCN2-MMP-9 axis. Pharmacological inhibition of MMP-9 could overcome resistance to almonertinib, as evidenced in both in vitro and in vivo models. Our findings suggest that LCN2 was a crucial regulator for conferring almonertinib-resistance in NSCLC and demonstrate the potential utility of targeting the LCN2-MMP-9 axis for clinical treatment of almonertinib-resistant lung adenocarcinoma.

Hierarchical Wrinkles with Piezopotential Enhanced Surface Tribopolarity for High-Performance Self-Powered Pressure Sensor.

Achieving both high sensitivity and wide detecting range is significant for the applications of triboelectric nanogenerator-based self-powered pressure sensors (TPSs). However, most of the previous designs with high sensitivity usually struggle in a narrow pressure detection range (<30 kPa) while expanding the detection range normally sacrifices the sensitivity. To overcome this well-known obstacle, herein, piezopotential enhanced triboelectric effect realized by a rationally designed PDMS/ZnO NWs hierarchical wrinkle structure was exploited to develop a TPS (PETPS) with both high sensitivity and wide detecting range. In this PETPS design, the piezopotential derived from the deformation of ZnO NWs enhances its tribo-charge transferring ability; meanwhile, the hierarchical structure helps to establish a dynamically self-adjustable contact area. Benefiting from these advantages, the PETPS simultaneously achieves high sensitivity (0.26 nC cm-2 kPa-1 from 1 to 25 kPa, and 0.02 nC cm-2 kPa-1 from 25 to 476 kPa), fast response (46 ms), wide sensing range (1 to 476 kPa), and good stability (over 4000 cycles). In addition, the output charge density that is independent of the speed rate of driven force was adopted as the sensing signal of PETPS to replace the commonly used peak voltage/current values, enabling it more adaptive to accurately detect pressure variation in real applications.

Effects of Selenium Dietary Yeast on Growth Performance, Slaughter Performance, Antioxidant Capacity, and Selenium Deposition in Broiler Chickens.

Selenium (Se) yeast, a bioavailable form of selenium, exhibits enhanced bioavailability due to its unique organic matrix and superior metabolic availability compared to the inorganic selenium sources. This study aims to evaluate the effects of Se yeast on the growth performance, slaughter performance, antioxidant capacity, and Se deposition in broiler chickens. A total of 264 1-day-old male AA broilers (38.7 ± 0.1 g) were randomly assigned to four treatment groups, with six replicates of 11 chickens per replicate. The broilers were fed a basal diet or a diet supplemented with 0.1, 0.2, and 0.4 mg/kg Se yeast. The experiment lasted for 42 days. Although the results showed that Se yeast did not significantly improve the growth performance of broilers, it did significantly decrease the abdominal fat ratio. Additionally, supplementation of Se yeast significantly improved the antioxidant capacity of broilers. The quadratic regression models were used to simulate the relationship between Se content in the feed and Se deposition in broiler tissues. The regression equations were as follows: pectoral muscle, Y = 2.628X - 0.340X2 - 0.592 (R2 = 0.927); leg muscle, Y = 2.317X - 0.272X2 - 0.490 (R2 = 0.937); liver, Y = 3.357X - 0.453X2 - 0.493 (R2 = 0.961); kidney, Y = 4.084X - 0.649X2 + 0.792 (R2 = 0.932). Based on these findings, the Se deposition in broiler tissues can be predicted by the Se content of the additive, which is of great significance for the precise production of Se-enriched functional chicken products.

Cross-Compatibility in Interspecific Hybridization of Different Curcuma Accessions.

Curcuma is extensively cultivated as a medicinal and ornamental plant in tropical and subtropical regions. Due to the bright bract color, distinctive inflorescence and long blooming period, it has become a new favorite in terms of the urban landscape, potted flowers and cut flowers. However, little research on breeding new cultivars using traditional plant breeding methods is available on the genus Curcuma. In the present study, pollen viability and stigma receptivity evaluation were performed, and the genetic relationship of 38 Curcuma accessions was evaluated, then 5 C. alismatifolia Gagnep. (Ca), 2 C. hybrid (Ch), 2 C. sparganiifolia Gagnep. cultivars and 4 Curcuma native species were selected as parents for subsequent interspecific cross-breeding. A total of 132 reciprocal crosses were carried out for interspecific hybridization, including 70 obverse and 62 inverse crosses. Obvious discrepancies among fruit-setting rates were manifested in different combinations and in reciprocal crosses. Results showed that the highest fruit-setting rate (87.5%) was observed in the Ca combinations. There were 87 combinations with a fruit-setting rate of 0%, which meant nearly 65.9% was incompatible. We concluded that C. alismatifolia 'Siam Shadow' (Ch34) was suitable as a male parent and C. petiolata Roxb. (Cpet) was suitable as a female parent to improve the fruit-setting rates. The maximum number of seeds per fruit (45.4) was obtained when C. alismatifolia 'Chiang Mai Pink' (Ca01) was used as a female parent followed by C. attenuata Wall. ex Baker (Catt) (42.8) and C. alismatifolia 'Splash' (Ca63) (39.6) as male parents. The highest germination rate was observed for the Ca group followed by Catt and C. sparganiifolia 'Maetang Sunrise' (Csms). The germination rates of Ca accessions ranged from 58.2% (C. alismatifolia 'Siam Scarlet' (Ca06) as a male parent) to 89.3% (C. alismatifolia 'Sitone' (Ca10) as a male parent) with an average value of 74.0%. Based on the results of hybrid identification, all the individuals from the four combinations exhibited paternal-specific bands, indicating that the true hybrid rates of crossings were 100%. Our results would facilitate the interspecific hybridization and introduction of genetic variation from wild species into the cultivars in Curcuma in the future, which could be helpful in realizing the sustainable application in urban green areas.

Antitumor activity of aumolertinib, a third-generation EGFR tyrosine kinase inhibitor, in non-small-cell lung cancer harboring uncommon EGFR mutations.

Uncommon epidermal growth factor receptor (EGFR) mutations account for 10%-20% of all EGFR mutations in non-small-cell lung cancer (NSCLC). The uncommon EGFR-mutated NSCLC is associated with poor clinical outcomes and generally achieved unsatisfactory effects to the current therapies using standard EGFR-tyrosine kinase inhibitors (TKIs), including afatinib and osimertinib. Therefore, it is necessary to develop more novel EGFR-TKIs to treat uncommon EGFR-mutated NSCLC. Aumolertinib is a third-generation EGFR-TKI approved in China for treating advanced NSCLC with common EGFR mutations. However, it remains unclear whether aumolertinib is effective in uncommon EGFR-mutated NSCLC. In this work, the in vitro anticancer activity of aumolertinib was investigated in engineered Ba/F3 cells and patient-derived cells bearing diverse uncommon EGFR mutations. Aumolertinib was shown to be more potent in inhibiting the viability of various uncommon EGFR-mutated cell lines than those with wild-type EGFR. And in vivo, aumolertinib could also significantly inhibit tumor growth in two mouse allograft models (V769-D770insASV and L861Q mutations) and a patient-derived xenografts model (H773-V774insNPH mutation). Importantly, aumolertinib exerts responses against tumors in advanced NSCLC patients with uncommon EGFR mutations. These results suggest that aumolertinib has the potential as a promising therapeutic candidate for the treatment of uncommon EGFR-mutated NSCLC.

Efficient Bayesian Policy Reuse With a Scalable Observation Model in Deep Reinforcement Learning.

Bayesian policy reuse (BPR) is a general policy transfer framework for selecting a source policy from an offline library by inferring the task belief based on some observation signals and a trained observation model. In this article, we propose an improved BPR method to achieve more efficient policy transfer in deep reinforcement learning (DRL). First, most BPR algorithms use the episodic return as the observation signal that contains limited information and cannot be obtained until the end of an episode. Instead, we employ the state transition sample, which is informative and instantaneous, as the observation signal for faster and more accurate task inference. Second, BPR algorithms usually require numerous samples to estimate the probability distribution of the tabular-based observation model, which may be expensive and even infeasible to learn and maintain, especially when using the state transition sample as the signal. Hence, we propose a scalable observation model based on fitting state transition functions of source tasks from only a small number of samples, which can generalize to any signals observed in the target task. Moreover, we extend the offline-mode BPR to the continual learning setting by expanding the scalable observation model in a plug-and-play fashion, which can avoid negative transfer when faced with new unknown tasks. Experimental results show that our method can consistently facilitate faster and more efficient policy transfer.

Development and validation of a nomogram for predicting dysphagia in long-term care facility residents.

BACKGROUND: Dysphagia is a common problem that can seriously affect the health of elderly residents in long-term care facilities. Early identification and targeted measures can significantly reduce the incidence of dysphagia. AIM: This study aims to establish a nomogram to evaluate the risk of dysphagia for elderly residents in long-term care facilities. METHODS: A total of 409 older adults were included in the development set, and 109 were included in the validation set. Least absolute shrinkage selection operator (LASSO) regression analysis was used to select the predictor variables, and logistic regression was used to establish the prediction model. The nomogram was constructed based on the results of logistic regression. The performance of the nomogram was evaluated by receiver operating characteristic (ROC) curve, calibration, and decision curve analysis (DCA). Internal validation was performed using tenfold cross-validation with 1000 iterations. RESULTS: The predictive nomogram included the following variables: stroke, sputum suction history (within one year), Barthel Index (BI), nutrition status, and texture-modified food. The area under the curve (AUC) for the model was 0.800; the AUC value for the internal validation set was 0.791, and the AUC value for the external validation set was 0.824. The nomogram showed good calibration in both the development set and validation set. Decision curve analysis (DCA) demonstrated that the nomogram was clinically valuable. DISCUSSION: This predictive nomogram provides a practical tool for predicting dysphagia. The variables included in this nomogram were easy to assess. CONCLUSIONS: The nomogram may help long-term care facility staff identify older adults at high risk for dysphagia.

Functions of Snake Sloughs in Bird Nests Vary with Habitats: A Test of the Anti-Predation Hypothesis.

Snake sloughs in bird nests can reduce nest predation and serve as an anti-predator strategy. However, the anti-predator function of snake sloughs in nests has only been tested twice, and it is difficult to speculate around the origin of the differences, which may well include habitat, as predator species and predation risk vary in different habitat types. Habitat would be a good place to speculate as to how differences in habitats could explain differences in responses by nest predators. Thus, we selected three different habitats, namely, the Diaoluoshan National Nature Reserve in Hainan (DLS, tropical forest), the Hainan Normal University campus (HNU, urban area), and Qingchuifeng National Forest Park in Hebei (QCF, suburban area), to verify the anti-predator function of snake sloughs in bird nests. The experimental results showed that snake sloughs in the nests reduced the predation rate of the experimental nests in HNU, whereas no such effect occurred in DLS and QCF. This suggests that the anti-predatory function of snake sloughs may not be the same over some environmental gradients and could be dependent on the species of nest predators and food resources in the habitat, which does not apply to all types of habitats.

Corrigendum to "Treatment-related adverse events associated with HER2-Targeted antibody-drug conjugates in clinical trials: a systematic review and meta-analysis" [EClinicalMedicine 55 (2022) 101795].

[This corrects the article DOI: 10.1016/j.eclinm.2023.101904.][This corrects the article DOI: 10.1016/j.eclinm.2022.101795.].

Multidisciplinary Guidelines for the Rational Use of Topical Non-Steroidal Anti-Inflammatory Drugs for Musculoskeletal Pain (2022).

(1) Background: Topical non-steroidal anti-inflammatory drugs (NSAIDs) are one of the primary drugs for treating musculoskeletal pain. However, there are currently no evidence-based recommendations about drug selection, drug administration, drug interactions, and use in special populations or other pharmacology-related content of such medications. To this end, the Chinese Pharmaceutical Association Hospital Pharmacy Professional Committee developed multidisciplinary guidelines on using topical NSAIDs to treat musculoskeletal pain. (2) Methods: The guidelines development process followed the World Health Organization guideline development handbook, the GRADE methodology, and the statement of Reporting Items for Practice Guidelines in Healthcare. The guideline panel used the Delphi method to identify six clinical questions to be addressed in the guidelines. An independent systematic review team conducted a systematic search and integration of evidence. (3) Results: Based on the balance between the benefits and harms of an intervention, the quality of the evidence, patient preferences and values, and resource utilization, the guideline panel developed 11 recommendations and nine expert consensuses on using topical NSAIDs to treat acute and chronic musculoskeletal pain. (4) Conclusions: Based on the effectiveness and overall safety of topical NSAIDs, we recommend patients with musculoskeletal pain use topical NSAIDs and suggest high-risk patients use topical NSAIDs, such as those with other diseases or receiving other concurrent treatments. The evidenced-based guidelines on topical NSAIDs for musculoskeletal pain incorporated a pharmacist perspective. The guidelines have the potential to facilitate the rational use of topical NSAIDs. The guideline panel will monitor the relevant evidence and update the recommendations accordingly.

Treatment-related adverse events associated with HER2-Targeted antibody-drug conjugates in clinical trials: a systematic review and meta-analysis.

Background: Given the increasing use of HER2-targeted antibody-drug conjugates (ADCs) worldwide, the summary of toxicity incidence and profiles of these drugs is crucial to provide reference for clinical application. This meta-analysis aimed to estimate the mean incidences of treatment-related adverse events of HER2-targeted ADCs and to investigate the differences between different drugs and cancer types. Methods: We performed a systematic search of literature in PubMed, Embase, Web of Science, and Scopus databases from inception to February 1, 2022 and the last search was updated to August 1, 2022. Published prospective clinical trials on single-agent of the US Food and Drug Administration approved HER2-targeted ADCs with available count data regarding treatment-related adverse events were included. The primary outcomes were pooled incidences of treatment-related adverse events and differences between different drugs and cancer types. The data synthesis was performed using a Bayesian hierarchical modelling method and the protocol was registered in PROSPERO (CRD42022331627). Findings: A total of 39 studies (37 trials) involving 7688 patients across five cancer types were included in the final analysis. On pooling the data using Bayesian hierarchical modelling, the overall mean incidence of all-grade adverse events, high-grade adverse events, serious adverse events, and adverse events that resulted in drug discontinuation were 98.29% (95% CrI, 97.33%-99.07%, τ = 1.49), 47.88% (95% CrI, 42.74%-53.17%, τ = 0.37), 19.45% (95% CrI, 15.70%-23.67%, τ = 0.55), and 10.52% (95% CrI, 8.03%-13.21%, τ = 0.56), respectively. The most common all-grade adverse events were nausea (41.57%; 95% CrI, 40.46%-42.64%, τ = 0.81), fatigue (35.86%; 95% CrI, 34.85%-36.96%, τ = 0.65), and decreased appetite (28.84%; 95% CrI, 22.93%-36.87%, τ = 0.76). The most common high-grade adverse events were thrombocytopenia (8.37%; 95% CrI, 7.75%-9.07%, τ = 0.71), anaemia (6.49%; 95% CrI, 5.86%-7.11%, τ = 1.06), and neutropenia (6.42%; 95% CrI, 5.76%-7.04%, τ = 1.21). We found no difference in the mean incidences of adverse events among different cancer types, as well as different dosing regimens. However, trastuzumab deruxtecan (T-DXd) appeared to have higher mean incidences of adverse events compared with trastuzumab emtansine (T-DM1), especially for the higher dose of T-DXd (6.4 mg/kg Q3W). Interpretation: The incidences of adverse events between two HER2-targeted ADCs were similar in different cancer types, but different HER2-targeted ADCs appeared to have different mean incidences of adverse events. The comprehensive summary of the adverse events of HER2-targeted ADCs is critical for clinicians caring for patients with cancer receiving HER2-targeted ADCs therapy. Funding: The National Natural Science Foundation of China (Grant No. 82073402) and Key R&D Plan of Hubei Province, China (No.2020BCA060) funded this study.

Diversity, classification, and EST-SSR-based association analysis of caladium ornamental traits.

Caladium (Caladium × Hortulanum Birdsey) is a popular ornamental plant with a wide range of vibrant leaf color among Araceae. Even after years of breeding, creating new caladium leaf color variations is extremely difficult. Molecular marker-assisted selection is an effective approach for accelerating breeding, but few studies on the molecular markers associated with caladium traits have been performed. In the current study, 144 caladium accessions were used to examine 12 phenotypic characteristics. The coefficient of variation for four numerical characters ranged from 23.94% to 43.22%, and the Shannon-Wiener indexes for eight descriptive characters ranged from 0.13 to 1.52. Based on L*, a*, b*, C, h° values determined by a colorimeter and hierarchical cluster analysis, the leaf color can be divided into four groups: pale green, green, light pink, and red. Furthermore, 7708 new SSR loci were identified by transcriptome sequencing, and 26 SSR markers with high polymorphism and reproducibility were screened. Genetic structure, NJ clustering, and PCoA analysis revealed that 144 accessions could be divided into three clusters, with genetic structure being closely related to germplasm origin. An association analysis revealed that the SSR markers 2, 1, 1, 1, 1, and 1 were mainly associated with petiole color, main vein color, blade upperside glossiness, and C, b*, and L* of leaf color (p < 0.01). These findings will serve as a valuable reference for evaluating germplasm resources and caladium molecular marker-assisted breeding.