Cold waves and fine particulate matter in high-altitude Chinese cities: assessing their interactive impact on outpatient visits for respiratory disease.

BACKGROUND: Extreme weather events like heatwaves and fine particulate matter (PM2.5) have a synergistic effect on mortality, but research on the synergistic effect of cold waves and PM2.5 on outpatient visits for respiratory disease, especially at high altitudes in climate change-sensitive areas, is lacking. METHODS: we collected time-series data on meteorological, air pollution, and outpatient visits for respiratory disease in Xining. We examined the associations between cold waves, PM2.5, and outpatient visits for respiratory disease using a time-stratified case-crossover approach and distributional lag nonlinear modeling. Our analysis also calculated the relative excess odds due to interaction (REOI), proportion attributable to interaction (AP), and synergy index (S). We additionally analyzed cold waves over time to verify climate change. RESULTS: Under different definitions of cold waves, the odds ratio for the correlation between cold waves and outpatient visits for respiratory disease ranged from 0.95 (95% CI: 0.86, 1.05) to 1.58 (1.47, 1.70). Exposure to PM2.5 was significantly associated with an increase in outpatient visits for respiratory disease. We found that cold waves can synergize with PM2.5 to increase outpatient visits for respiratory disease (REOI > 0, AP > 0, S > 1), decreasing with stricter definitions of cold waves and longer durations. Cold waves' independent effect decreased over time, but their interaction effect persisted. From 8.1 to 21.8% of outpatient visits were due to cold waves and high-level PM2.5. People aged 0-14 and ≥ 65 were more susceptible to cold waves and PM2.5, with a significant interaction for those aged 15-64 and ≥ 65. CONCLUSION: Our study fills the gap on how extreme weather and PM2.5 synergistically affect respiratory disease outpatient visits in high-altitude regions. The synergy of cold waves and PM2.5 increases outpatient visits for respiratory disease, especially in the elderly. Cold wave warnings and PM2.5 reduction have major public health benefits.

Effects of the interaction between cold spells and fine particulate matter on mortality risk in Xining: a case-crossover study at high altitude.

Background: With global climate change, the health impacts of cold spells and air pollution caused by PM2.5 are increasingly aggravated, especially in high-altitude areas, which are particularly sensitive. Exploring their interactions is crucial for public health. Methods: We collected time-series data on meteorology, air pollution, and various causes of death in Xining. This study employed a time-stratified case-crossover design and conditional logistic regression models to explore the association between cold spells, PM2.5 exposure, and various causes of death, and to assess their interaction. We quantitatively analyzed the interaction using the relative excess odds due to interaction (REOI), attributable proportion due to interaction (AP), and synergy index (S). Moreover, we conducted stratified analyses by average altitude, sex, age, and educational level to identify potential vulnerable groups. Results: We found significant associations between cold spells, PM2.5, and various causes of death, with noticeable effects on respiratory disease mortality and COPD mortality. We identified significant synergistic effects (REOI>0, AP > 0, S > 1) between cold spells and PM2.5 on various causes of death, which generally weakened with a stricter definition of cold spells and longer duration. It was estimated that up to 9.56% of non-accidental deaths could be attributed to concurrent exposure to cold spells and high-level PM2.5. High-altitude areas, males, the older adults, and individuals with lower educational levels were more sensitive. The interaction mainly varied among age groups, indicating significant impacts and a synergistic action that increased mortality risk. Conclusion: Our study found that in high-altitude areas, exposure to cold spells and PM2.5 significantly increased the mortality risk from specific diseases among the older adults, males, and those with lower educational levels, and there was an interaction between cold spells and PM2.5. The results underscore the importance of reducing these exposures to protect public health.

A potential strategy for bladder cancer treatment: inhibiting autophagy to enhance antitumor effects of Nectin-4-MMAE.

Research and development on Nectin-4 antibody-drug conjugates (ADC) have been greatly accelerated since the approval of enfortumab vedotin to treat uroepithelial cancer. During the course of this study, we identified that autophagy serves as a cytoprotective mechanism during Nectin-4-MMAE treatment and proposed a strategy to enhance the antitumor effects of Nectin-4-MMAE in bladder cancer. Nectin-4-MMAE rapidly internalized into bladder cancer cells in 30 minutes and released MMAE, inducing the onset of caspase-mediated apoptosis and leading to the inhibition of tumor cell growth. Transcriptomics showed significant alterations in autophagy-associated genes in bladder cancer cells treated with Nectin-4-MMAE, which suggested autophagy was activated by Nectin-4-MMAE. Furthermore, autophagy activation was characterized by ultrastructural analysis of autophagosome accumulation, immunofluorescence of autophagic flux, and immunoblotting autophagy marker proteins SQSTM1 and LC3 I/II. Importantly, inhibiting autophagy by LY294002 and chloroquine significantly enhances the cytotoxicity effects of Nectin-4-MMAE in bladder cancer cells. Additionally, we detected the participation of the AKT/mTOR signaling cascade in the induction of autophagy by Nectin-4-MMAE. The combination of Nectin-4-MMAE and an autophagy inhibitor demonstrated enhanced antitumor effects in the HT1376 xenograft tumor model. After receiving a single dose of Nectin-4-MMAE, the group that received the combination treatment showed a significant decrease in tumor size compared to the group that received only one type of treatment. Notably, one mouse in the combination treatment group achieved complete remission of the tumor. The combination group exhibited a notable rise in apoptosis and necrosis, as indicated by H&E staining and immunohistochemistry (cleaved caspase-3, ki67). These findings demonstrated the cytoprotective role of autophagy during Nectin-4-MMAE treatment and highlighted the potential of combining Nectin-4-MMAE with autophagy inhibitors for bladder cancer treatment.

Health impacts of a cold wave and its economic loss assessment in China's high-altitude city, Xining.

OBJECTIVE: Amidst climate change, extensive research has centered on the health impacts of heatwaves, yet the consequences of cold spells, particularly in cooler, higher-altitude regions, remain under-explored. METHODS: Analyzing climatic data and non-accidental mortality in Xining, China's second-highest provincial capital, from 2016 to 2020, this study defines cold spells as daily mean temperatures below the 10th, 7.5th, or 5th percentiles for 2-4 consecutive days. A time-stratified case-crossover approach and distributional lag nonlinear modeling were used to assess the link between cold spells and mortality, calculating attributable fractions (AFs) and numbers (ANs) of deaths. The study also examined the impact of cold spells over different periods and analyzed the value of a statistical life (VSL) loss in 2018, a year with frequent cold spells. Stratified analyses by sex, age, and education level were conducted. RESULTS: A significant association was found between cold spells and non-accidental mortality, with a relative risk of 1.548 (95% CI: 1.300, 1.845). The AF was 33.48%, with an AN of 9,196 deaths during the study's cold period. A declining trend in mortality risk was observed from 2019-2020. The 2018 VSL was approximately 2.875 billion CNY, about 1.75% of Xining's GDP. Higher risks were noted among males, individuals aged ≥ 65, and those with lower education levels. CONCLUSION: The findings underscore the vulnerability and economic losses of high-altitude cities to cold spells. Implementing interventions such as improved heating, educational programs, and community support is vital for mitigating these adverse health effects.

Self-pulsing and dual-mode lasing in a square microcavity semiconductor laser.

Self-pulsing and dual-mode lasing in a square microcavity semiconductor laser are studied experimentally. Self-sustained pulses originating from undamped relaxation oscillation induced by a two-mode interaction are obtained, as the injection current is slightly above the laser threshold. A repetition frequency of 4.4 GHz and a pulse width of 30-40 ps are obtained at a current of 8 mA. The laser switches to continuous-wave operation when the injection current is higher than a certain value, and dual-mode lasing with 30.7 GHz at 16 mA and 10.7 GHz at 27 mA are observed in the lasing spectra. Furthermore, the relative intensity noise spectra are presented to reveal the relationship between the lasing states and the dynamics induced by relaxation oscillation and mode beating.

Chaotic microlasers caused by internal mode interaction for random number generation.

Chaotic semiconductor lasers have been widely investigated for generating unpredictable random numbers, especially for lasers with external optical feedback. Nevertheless, chaotic lasers under external feedback are hindered by external feedback loop time, which causes correlation peaks for chaotic output. Here, we demonstrate the first self-chaotic microlaser based on internal mode interaction for a dual-mode microcavity laser, and realize random number generation using the self-chaotic laser output. By adjusting mode frequency interval close to the intrinsic relaxation oscillation frequency, nonlinear dynamics including self-chaos and period-oscillations are predicted and realized numerically and experimentally due to internal mode interaction. The internal mode interaction and corresponding carrier spatial oscillations pave the way of mode engineering for nonlinear dynamics in a solitary laser. Our findings provide a novel and easy method to create controllable and robust optical chaos for high-speed random number generation.

miR-184-5p inhibits cell proliferation, invasion and predicts prognosis of clear cell renal cell carcinoma by targeting NUS1 dehydrodolichyl diphosphate synthase subunit: Results from large-scale comprehensive identification and validation.

Clear cell renal cell carcinoma (ccRCC) has become a common malignant cancer with increasing incidence rate and high recurrence risk in genitourinary oncology around the world. Recently, miRNAs were identified to affect pathogenesis, development, molecular functions, and prognosis of ccRCC. In this study, microRNA-184-5p (miR-184-5p) was identified from three independent ccRCC cohorts and was determined as a significantly distinct prognostic biomarker. Relative miR-184-5p expression was found in A-498 and 786-O ccRCC cells compared with HK-2 cells. After ccRCC cells were transfected with miR-184-5p mimics or inhibitor, biological abilities of miR-184-5p in tumor cell proliferation, cycle, apoptosis and invasion were determined. Additionally, we confirmed the direct relationship between miR-184-5p and NUS1 dehydrodolichyl diphosphate synthase subunit (NUS1) by using the Luciferase reporter and rescue assays. These results indicated that the expression level of miR-184-5p in human ccRCC cells and tissues was reduced, and the up-regulation of miR-184-5p regulated A-498 and 786-O cell proliferation, invasion and apoptosis by directly targeting NUS1. These findings may provide new theoretical targets for treatment strategies and drug development of ccRCC.

Effect of previous Chlamydia Trachomatis infection on the outcomes of ivf/icsi treatment: a retrospective study.

BACKGROUND: The impact of Chlamydia trachomatis infection (CT) on the outcomes of In-Vitro Fertilization / Intracytoplasmic sperm injection (IVF/ICSI) has been controversial. METHODS: A total of 431 infertility women aged 20-38 years with or without Chlamydia trachomatis infection before fresh/ frozen embryo transfer were included to investigate the effect of cured CT infection. The infected group was divided into two subgroups for ≤3 months and > 3 months according to the different intervals between Chlamydia trachomatis positive testing and embryo transfer. The effect of chlamydia infection and the intervals between infection and embryo transfer on pregnancy outcomes was analyzed with correction for potential confounders within a multivariable model. RESULTS: Our results revealed that implantation rate was significantly lower and the premature rupture of membranes (PROM) was higher in women with CT infection than non-infection. The multivariate logistic regression analysis adjusting for baseline characteristics showed no significant difference in live birth rate between neither two groups nor two subgroups. CONCLUSIONS: The study suggests that previous Chlamydia trachomatis infection would lead to high risk of PROM. The intervals between infection and embryo transfer would not impact the pregnancy outcomes of IVF/ICSI.

Integrating lncRNAs and mRNAs Expression Profiles in Penicillin-Induced Persistent Chlamydial Infection in HeLa Cells.

Chlamydia trachomatis (C. trachomatis) is a major etiological agent of sexually transmitted infection. Some stressing conditions can result in persistent chlamydial infection, which is thought to be associated with severe complications including ectopic pregnancy and tubal factor infertility. Long noncoding RNAs (lncRNAs) have been identified as key modulators in many biological processes. Nevertheless, the role of lncRNAs in persistent chlamydial infection is still unclear. In this study, we used lncRNA and mRNA microarray to identify the global lncRNAs and mRNAs expression in penicillin-induced persistent chlamydial infection in HeLa cells as well as the control group (HeLa cells without C. trachomatis infection). Among 1005 differentially expressed lncRNAs, 585 lncRNAs were upregulated and 420 downregulated in persistent chlamydial infection, while 410 mRNAs were identified to express differentially, of which 113 mRNAs were upregulated and 297 downregulated. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis with differentially expressed genes were performed. We then constructed the lncRNA-miRNA-mRNA competing endogenous RNAs (ceRNAs) network. Four mRNAs were validated to be changed by quantitative real-time PCR which were correlated with the microarray result. Integration of protein-protein interaction network was constructed and hub genes were identified. These findings provide a new perspective on the molecular mechanisms of penicillin-induced persistent chlamydial infection.

Wideband chaotic tri-mode microlasers with optical feedback.

A tri-mode micro-square laser under optical feedback is proposed and demonstrated to generate chaos with the broadband flat microwave spectrum. By adjusting lasing mode intensities, frequency intervals, and optical feedback strength, we can enhance the chaotic bandwidth significantly. The existence of two mode-beating peaks makes the flat bandwidth much larger than the relaxation oscillation frequency. Effective bandwidth of 35.3 GHz is experimentally achieved with the flatness of 8.3 dB from the chaotic output spectrum of the tri-mode mode laser under optical feedback.

Prognostic value, DNA variation and immunologic features of a tertiary lymphoid structure-related chemokine signature in clear cell renal cell carcinoma.

BACKGROUND: The tumor microenvironment (TME) and tertiary lymphoid structures (TLS) affect the occurrence and development of cancers. How the immune contexture interacts with the phenotype of clear cell renal cell carcinoma (ccRCC) remains unclear. METHODS: We identified and evaluated TLS clusters in ccRCC using machine learning algorithms and the 12-chemokine gene signature for TLS. Analyses for functional enrichment, DNA variation, immune cell distribution, association with independent clinicopathological features and predictive value of CXCL13 in ccRCC were performed. RESULTS: We found a prominently enrichment of the 12-chemokine gene signature for TLS in patients with ccRCC compared with other types of renal cell carcinoma. We identified a prognostic value of CCL4, CCL5, CCL8, CCL19 and CXCL13 expression in ccRCC. DNA deletion of the TLS gene signature significantly predicted poor outcome in ccRCC compared with amplification and wild-type gene signature. We established TLS clusters (C1-4) and observed distinct differences in survival, stem cell-like characteristics, immune cell distribution, response to immunotherapies and VEGF-targeted therapies among the clusters. We found that elevated CXCL13 expression significantly predicted aggressive progression and poor prognosis in 232 patients with ccRCC in a real-world validation cohort. CONCLUSION: This study described a 12-chemokine gene signature for TLS in ccRCC and established TLS clusters that reflected different TME immune status and corresponded to prognosis of ccRCC. We confirmed the dense presence of TILs aggregation and TLS in ccRCC and demonstrated an oncogenic role of CXCL13 expression of ccRCC, which help develop immunotherapies and provide novel insights on the long-term management of ccRCC.

Prognostic Immunophenotyping Clusters of Clear Cell Renal Cell Carcinoma Defined by the Unique Tumor Immune Microenvironment.

Background: The tumor microenvironment affects the occurrence and development of cancers, including clear cell renal cell carcinoma (ccRCC). However, how the immune contexture interacts with the cancer phenotype remains unclear. Methods: We identified and evaluated immunophenotyping clusters in ccRCC using machine-learning algorithms. Analyses for functional enrichment, DNA variation, immune cell distribution, association with independent clinicopathological features, and predictive responses for immune checkpoint therapies were performed and validated. Results: Three immunophenotyping clusters with gradual levels of immune infiltration were identified. The intermediate and high immune infiltration clusters (Clusters B and C) were associated with a worse prognosis for ccRCC patients. Tumors in the immune-hot Clusters B and C showed pro-tumorigenic immune infiltration, and these patients showed significantly worse survival compared with patients in the immune-cold Cluster A in the training and testing cohorts (n = 422). In addition to distinct immune cell infiltrations of immunophenotyping, we detected significant differences in DNA variation among clusters, suggesting a high degree of genetic heterogeneity. Furthermore, expressions of multiple immune checkpoint molecules were significantly increased. Clusters B and C predicted favorable outcomes in 64 ccRCC patients receiving immune checkpoint therapies from the FUSCC cohort. In 360 ccRCC patients from the FUSCC validation cohort, Clusters B and C significantly predicted worse prognosis compared with Cluster A. After immunophenotyping of ccRCC was confirmed, significantly increased tertiary lymphatic structures, aggressive phenotype, elevated glycolysis and PD-L1 expression, higher abundance of CD8+ T cells, and TCRn cell infiltration were found in the immune-hot Clusters B and C. Conclusion: This study described immunophenotyping clusters that improved the prognostic accuracy of the immune contexture in the ccRCC microenvironment. Our discovery of the novel independent prognostic indicators in ccRCC highlights the relationship between tumor phenotype and immune microenvironment.

LncRNA RP11-89 facilitates tumorigenesis and ferroptosis resistance through PROM2-activated iron export by sponging miR-129-5p in bladder cancer.

Long non-coding RNAs (lncRNAs) act as important regulators of tumorigenesis and development in bladder cancer. However, the underlying molecular mechanisms remain elusive. We previously identified a novel lncRNA signature related to immunity and progression in bladder cancer. Here we further explored the function of RP11-89, a lncRNA discovered in the previous signature. Loss- and gain-of function experiments were performed using CCK-8 assay, flow cytometry, Transwell assays, scratch tests and subcutaneous nude mouse models. High-throughput RNA sequencing was conducted to identify dysregulated genes in bladder cancer cells with RP11-89 knockdown or overexpression. Regulation of RP11-89 on miR-129-5p and PROM2 was explored through luciferase reporter assay, RIP assay and RNA pull-down assay. RP11-89 promoted cell proliferation, migration and tumorigenesis and inhibited cell cycle arrest via the miR-129-5p/PROM2 axis. We found that RP11-89 "sponges" miR-129-5p and upregulates PROM2. Elevated PROM2 in cells was associated with attenuated ferroptosis through iron export, formation of multivesicular bodies and less mitochondrial abnormalities. We demonstrated that RP11-89 is a novel tumorigenic regulator that inhibits ferroptosis via PROM2-activated iron export. RP11-89 may serve as a potential biomarker for targeted therapy in bladder cancer.

Primary Eccrine Porocarcinoma of the Thumb With Metastasis: A Rare Case Report and Literature Review.

ABSTRACT: Eccrine porocarcinoma (EPC) is a rare malignant sweat gland tumor that accounts for approximately 0.005% of all cutaneous carcinomas. It favors the lower extremities. Only 3% of EPCs are on the hand, and only 6 cases occurring specifically on fingers have been previously documented. However, we met a patient with EPC presenting the primary lesion on the left thumb and an extensive cutaneous metastasis on the left forearm. Pathologic findings of axillary lymph nodes confirmed lymphatic metastasis.

Manipulation of lasing modes in a circular-side octagonal microcavity laser with a spatially distributed current injection.

We propose and demonstrate a circular-side octagonal microcavity (COM) semiconductor laser with a spatially distributed current injection for manipulating the lasing modes. There are two types of high-quality-factor whispering-gallery (WG) modes with distinct field patterns in a COM: the four-bounced quadrilateral modes and the eight-bounced octagonal modes. By designing two separated p-electrodes, the COM laser is divided into two regions that are pumped independently to select specific modes for lasing. The two types of WG modes lase simultaneously when the two regions are injected with equivalent currents. Degeneracy removal of the quadrilateral modes is observed in both simulation and experiment when the two regions are injected with inequivalent currents. The quadrilateral modes are suppressed when one of the two regions is un-injected or biased with a negative current, and single-octagonal-mode lasing is realized. The results show that the lasing modes can be efficiently manipulated with the spatially distributed current injection considering the distinct field patterns of different WG modes in the microcavities, which can promote the practical application of the microcavity lasers.

ALPK2 acts as tumor promotor in development of bladder cancer through targeting DEPDC1A.

Bladder cancer is one of the most common malignant tumors in the urinary system. The development and improvement of treatment efficiency require the deepening of the understanding of its molecular mechanism. This study investigated the role of ALPK2, which is rarely studied in malignant tumors, in the development of bladder cancer. Our results showed the upregulation of ALPK2 in bladder cancer, and data mining of TCGA database showed the association between ALPK2 and pathological parameters of patients with bladder cancer. In vitro and in vivo experiments demonstrated that knockdown of ALPK2 could inhibit bladder cancer development through regulating cell proliferation, cell apoptosis, and cell migration. Additionally, DEPDC1A is identified as a potential downstream of ALPK2 with direct interaction, whose overexpression/downregulation can inhibit/promote the malignant behavioral of bladder cancer cells. Moreover, the overexpression of DEPDC1A can rescue the inhibitory effects of ALPK2 knockdown on bladder cancer. In conclusion, ALPK2 exerts a cancer-promoting role in the development of bladder cancer by regulating DEPDC1A, which may become a promising target to improve the treatment strategy of bladder cancer.

Akt Phosphorylation Influences Persistent Chlamydial Infection and Chlamydia-Induced Golgi Fragmentation Without Involving Rab14.

Chlamydia trachomatis is an obligate intracellular bacterium that causes multiple diseases involving the eyes, gastrointestinal tract, and genitourinary system. Previous studies have identified that in acute chlamydial infection, C. trachomatis requires Akt pathway phosphorylation and Rab14-positive vesicles to transmit essential lipids from the Golgi apparatus in survival and replication. However, the roles that Akt phosphorylation and Rab14 play in persistent chlamydial infection remain unclear. Here, we discovered that the level of Akt phosphorylation was lower in persistent chlamydial infection, and positively correlated with the effect of activating the development of Chlamydia but did not change the infectivity and 16s rRNA gene expression. Rab14 was found to exert a limited effect on persistent infection. Akt phosphorylation might regulate Chlamydia development and Chlamydia-induced Golgi fragmentation in persistent infection without involving Rab14. Our results provide a new insight regarding the potential of synergistic repressive effects of an Akt inhibitor with antibiotics in the treatment of persistent chlamydial infection induced by penicillin.

Numerical simulation of all-optical logic gates based on hybrid-cavity semiconductor lasers.

All-optical switch and multiple logic gates have been demonstrated using a hybrid-cavity semiconductor laser composed of a square microcavity and a Fabry-Perot cavity experimentally. In this paper, two-section tri-mode rate equations with optical injection terms are proposed and applied to study all-optical logic gates of NOT, NOR, and NAND operations utilizing the hybrid-cavity laser. Steady-state and dynamical characteristics of all-optical multiple logic gates are simulated, taking into account the influence of mode frequency detuning, gain suppression coefficients, mode Q factor, injection energy, and biasing current. All-optical logic NOT, NOR, and NAND gates up to 20, 15, and 20 Gbit/s are obtained numerically with dynamic extinction ratios of over 20, 20, and 10 dB, respectively, which are potential response speeds of the all-optical logic gates based on the hybrid-cavity semiconductor lasers.

Multi-omics reveals novel prognostic implication of SRC protein expression in bladder cancer and its correlation with immunotherapy response.

PURPOSE: This study aims to identify potential prognostic biomarkers of bladder cancer (BCa) based on large-scale multi-omics data and investigate the role of SRC in improving predictive outcomes for BCa patients and those receiving immune checkpoint therapies (ICTs). METHODS: Large-scale multi-comic data were enrolled from the Cancer Proteome Atlas, the Cancer Genome Atlas and gene expression omnibus based on machining-learning methods. Immune infiltration, survival and other statistical analyses were implemented using R software in cancers (n = 12,452). The predictive value of SRC was performed in 81 BCa patients receiving ICT from aa validation cohort (n = 81). RESULTS: Landscape of novel candidate prognostic protein signatures of BCa patients was identified. Differential BECLIN, EGFR, PKCALPHA, ANNEXIN1, AXL and SRC expression significantly correlated with the outcomes for BCa patients from multiply cohorts (n = 906). Notably, risk score of the integrated prognosis-related proteins (IPRPs) model exhibited high diagnostic accuracy and consistent predictive ability (AUC = 0.714). Besides, we tested the clinical relevance of baseline SRC protein and mRNA expression in two independent confirmatory cohorts (n = 566) and the prognostic value in pan-cancers. Then, we found that elevated SRC expression contributed to immunosuppressive microenvironment mediated by immune checkpoint molecules of BCa and other cancers. Next, we validated SRC expression as a potential biomarker in predicting response to ICT in 81 BCa patient from FUSCC cohort, and found that expression of SRC in the baseline tumour tissues correlated with improved survival benefits, but predicts worse ICT response. CONCLUSION: This study first performed the large-scale multi-omics analysis, distinguished the IPRPs (BECLIN, EGFR, PKCALPHA, SRC, ANNEXIN1 and AXL) and revealed novel prediction model, outperforming the currently traditional prognostic indicators for anticipating BCa progression and better clinical strategies. Additionally, this study provided insight into the importance of biomarker SRC for better prognosis, which may inversely improve predictive outcomes for patients receiving ICT and enable patient selection for future clinical treatment.

Comparison of single- and dual-mode lasing states of a hybrid-cavity laser under optical feedback.

In this Letter, we design and realize a hybrid-cavity laser with single- or dual-mode lasing states and study the nonlinear states of the laser under external optical feedback (EOF). The laser at a dual-mode state easily and directly enters the chaotic state without periodic oscillation states and display chaos for a much wider range of the EOF magnitude than the laser at a single-mode state. A flat chaotic signal is obtained for the laser at a dual-mode lasing state under a weak EOF benefitting from the low-frequency energy enhancement caused by mode competition between the dual modes.