Association of Methylenetetrahydrofolate Reductase rs1801133 Polymorphism with osteoporosis and fracture risk in Taiwan.

Introduction: Osteoporosis is a prevalent skeletal disorder influenced by age, hormonal changes, medication use, nutrition, and genetics. The relationship between MTHFR and osteoporosis remains unclear, especially in Asians. The aim of our study was to elucidate the impact of MTHFR on osteoporosis and fracture risk. Materials and Methods: Participants were recruited from the Taiwan Precision Medicine Initiative at Taichung Veterans General Hospital. A total of 3,503 subjects with available bone mineral density measurements were selected. Using the Axiom Genome-Wide TWB 2.0 Array, we identified the MTHFR rs1801133 variant. Among these subjects, 1,624 patients carrying the variant were included in the case group, while the remaining 1,879 patients without the variant served as the control group. Results: Overall, individuals carrying the MTHFR rs1801133 variant exhibited a significantly elevated risk of developing osteoporosis. Stratified analysis by different genotypes, the results revealed a statistically significant association between the heterozygous genotype of MTHFR rs1801133 and osteoporosis. However, there was no significant correlation between MTHFR genotypes and fracture risk. Furthermore, subgroup analysis of female patients revealed age, a known risk factor, was associated with both osteoporosis and fractures. Interestingly, the presence of the MTHFR rs1801133 variant did not confer an increased risk of osteoporosis or fractures in females. Conclusion: Our study revealed a notable increase in the prevalence of osteoporosis among individuals carrying the MTHFR rs1801133 variant. Nevertheless, these individuals did not exhibit a heightened risk of major or hip fractures compared to non-carriers. Our findings could be of value in raising awareness of the increased risk of osteoporosis among individuals with this genetic variant.

A Hypoxia-Decidual Macrophage Regulatory Axis in Normal Pregnancy and Spontaneous Miscarriage.

The significance of hypoxia at the maternal-fetal interface is proven to be self-explanatory in the context of pregnancy. During the first trimester, low oxygen conditions play a crucial role in processes such as angiogenesis, trophoblast invasion and differentiation, and immune regulation. Recently, there has been increasing research on decidual macrophages, which contribute to the maintenance of immune tolerance, placental and fetal vascular development, and spiral artery remodeling, to investigate the effects of hypoxia on their biological behaviors. On these grounds, this review describes the dynamic changes in oxygen levels at the maternal-fetal interface throughout gestation, summarizing current knowledge on how the hypoxic environment sustains a successful pregnancy by regulating retention, differentiation and efferocytosis of decidual macrophages. Additionally, we explore the relationship between spontaneous miscarriages and an abnormal hypoxia-macrophage axis, shedding light on the underlying mechanisms. However, further studies are essential to elucidate these pathways in greater detail and to develop targeted interventions that could improve pregnancy outcomes.

Diagnostic performance of rapid on-site evaluation during bronchoscopy for lung cancer: A comprehensive meta-analysis.

BACKGROUND: Lung cancer is the leading cause of cancer-related mortality worldwide. Screening high-risk populations for lung cancer with low-dose computed tomography (LDCT) reduces lung cancer mortality. Bronchoscopy is a diagnostic procedure used to monitor patients suspected of having lung cancer after LDCT. Rapid on-site evaluation (ROSE) can improve the diagnostic accuracy of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), although its diagnostic value remains unclear. In this meta-analysis, the authors evaluated the diagnostic accuracy of ROSE during bronchoscopy. METHODS: The PubMed, Embase, and Cochrane Library databases were searched for studies evaluating the diagnostic accuracy of ROSE for lung cancer during bronchoscopy. Studies evaluating the performance of ROSE and articles providing sufficient data for constructing a 2 × 2 table on a per-lesion basis were included. A meta-analysis was conducted using a bivariate random-effects model. RESULTS: In total, 32 studies involving 8243 lung lesions were included with a pooled sensitivity of 91.8% and a pooled specificity of 94.9%. Subgroup analysis of 12 studies involving 2929 specimens from patients who underwent computed tomography revealed a pooled sensitivity of 93.8% and a pooled specificity of 96%. Further subgroup analysis of seven studies on the diagnostic outcomes of ROSE for intrathoracic or mediastinal lymph nodes through EBUS-TBNA for lung cancer staging revealed a pooled sensitivity of 90.1% and a pooled specificity of 96.9%. CONCLUSIONS: ROSE exhibited high sensitivity and specificity for diagnosing lung cancer during bronchoscopy. It also exhibited high sensitivity in detecting lung cancer in patients undergoing LDCT and higher specificity for nodal staging with EBUS-TBNA.

The association between the number of food kinds and risk of depression in U.S. adults.

BACKGROUND: The association between the number of food kinds and the risk of depression in adults was examined. METHODS: According to the inclusion and exclusion criteria, a total of 4593 adults were included in the study. The number of food kinds was collected via 24‒hour dietary recalls. Depression was assessed using the Patient Health Questionnaire‒9. Logistic regression and restricted cubic spline models were applied to assess the association between the number of food kinds and the risk of depression. RESULTS: This study included 4593 study participants, 451 of whom were diagnosed with depression. The revised advantage ratios (with corresponding confidence intervals) for the prevalence of depression among individuals in the fourth quartiles of the number of food kinds (Q4) in comparison to the lowest quartile (Q1) were determined to be 0.59 (0.36‒0.96), respectively. According to our subgroup analyses, the number of food kinds was negatively associated with the risk of depression in females, participants aged 18‒45 and 45‒65 years, and participants with a body mass index (BMI) of 25 to 24.9 kg/m2. According to our dose‒response analysis, the number of food kinds was linearly associated with the risk of depression (Pfor nonlinear=0.5896). CONCLUSION: The risk of depression exhibited a linear and negative correlation with the number of food kinds. The results indicated that a diversified diet was an effective nonpharmacological approach that deserved further generalization.

Systematic bibliometric and visualized analysis of research hotspots and trends on the application of artificial intelligence in glaucoma from 2013 to 2022.

AIM: To conduct a bibliometric analysis of research on artificial intelligence (AI) in the field of glaucoma to gain a comprehensive understanding of the current state of research and identify potential new directions for future studies. METHODS: Relevant articles on the application of AI in the field of glaucoma from the Web of Science Core Collection were retrieved, covering the period from January 1, 2013, to December 31, 2022. In order to assess the contributions and co-occurrence relationships among different countries/regions, institutions, authors, and journals, CiteSpace and VOSviewer software were employed and the research hotspots and future trends within the field were identified. RESULTS: A total of 750 English articles published between 2013 and 2022 were collected, and the number of publications exhibited an overall increasing trend. The majority of the articles were from China, followed by the United States and India. National University of Singapore, Chinese Academy of Sciences, and Sun Yat-sen University made significant contributions to the published works. Weinreb RN and Fu HZ ranked first among authors and cited authors. American Journal of Ophthalmology is the most impactful academic journal in the field of AI application in glaucoma. The disciplinary scope of this field includes ophthalmology, computer science, mathematics, molecular biology, genetics, and other related disciplines. The clustering and identification of keyword nodes in the co-occurrence network reveal the evolving landscape of AI application in the field of glaucoma. Initially, the hot topics in this field were primarily "segmentation", "classification" and "diagnosis". However, in recent years, the focus has shifted to "deep learning", "convolutional neural network" and "artificial intelligence". CONCLUSION: With the rapid development of AI technology, scholars have shown increasing interest in its application in the field of glaucoma. Moreover, the application of AI in assisting treatment and predicting prognosis in glaucoma may become a future research hotspot. However, the reliability and interpretability of AI data remain pressing issues that require resolution.

Association between pre-stroke frailty status and stroke risk and impact on outcomes: a systematic review and meta-analysis of 1,660,328 participants.

The prevalence of frailty is increasing, and it is associated with increased risk of diseases and adverse outcomes. Although substantial research has focused on post-stroke frailty, understanding of pre-stroke frailty remains limited. Our aim was to synthesize literature on pre-stroke frailty and stroke risk to explore their relationship and impact on prognosis. A systematic search of multiple databases was conducted to identify cohort studies published until October 28, 2023. Meta-analysis was conducted using a random effects model. Heterogeneity was assessed with the I² statistic, and publication bias was evaluated using Begg's test. Finally, we included 11 studies (n = 1,660,328 participants). The pooled hazard ratios (HRs) for stroke risk associated with pre-stroke frailty compared to non-frail individuals was 1.72 (95% confidence interval, CI: 1.46-2.02, p = 0.002, I2 = 69.2%, Begg's test: p = 0.536). The pooled HRs for mortality and the pooled relative risk (RRs) modified Rankin Scale (mRs) associated with pre-stroke frailty were 1.68 (95% CI: 1.10-2.56, p = 0.136, I2 = 49.9%, Begg's test: p = 0.296) and 3.11 (95% CI: 1.77-5.46, p = 0.192, I2 = 39.4%, Begg's test: p = 1.000), respectively. In conclusion, pre-stroke frailty is strongly associated with stroke risk and impacts its prognosis, irrespective of the measurement method. Future research should focus on prospective studies to assess the effects of early intervention for frailty. This has significant implications for primary healthcare services and frailty management.

A convenient research strategy for functional verification of epigenetic regulators during spermatogenesis.

Spermatogenesis is a fundamental process that requires a tightly controlled epigenetic event in spermatogonial stem cells (SSCs). The mechanisms underlying the transition from SSCs to sperm are largely unknown. Most studies utilize gene knockout mice to explain the mechanisms. However, the production of genetically engineered mice is costly and time-consuming. In this study, we presented a convenient research strategy using an RNA interference (RNAi) and testicular transplantation approach. Histone H3 lysine 9 (H3K9) methylation was dynamically regulated during spermatogenesis. As Jumonji domain-containing protein 1A (JMJD1A) and Jumonji domain-containing protein 2C (JMJD2C) demethylases catalyze histone H3 lysine 9 dimethylation (H3K9me2), we firstly analyzed the expression profile of the two demethylases and then investigated their function. Using the convenient research strategy, we showed that normal spermatogenesis is disrupted due to the downregulated expression of both demethylases. These results suggest that this strategy might be a simple and alternative approach for analyzing spermatogenesis relative to the gene knockout mice strategy.

One step toward precision dosing of caffeine in preterm infants: An external evaluation of published population pharmacokinetic models.

BACKGROUND: Several population pharmacokinetic (PopPK) models of caffeine in preterm infants have been published, but the extrapolation of these models to facilitate model-informed precision dosing (MIPD) in clinical practice is uncertain. This study aimed to comprehensively evaluate their predictive performance using an external, independent dataset. METHODS: Data used for external evaluation were based on an independent cohort of preterm infants. Currently available PopPK models for caffeine in preterm infants were identified and re-established. Prediction- and simulation-based diagnostics were used to assess model predictability. The influence of prior information was assessed using Bayesian forecasting. RESULTS: 120 plasma samples from 76 preterm infants were included in the evaluation dataset. Twelve PopPK models of caffeine in preterm infants were re-established based on our previously published study. Although two models showed superior predictive performance, none of the 12 PopPK models met all the clinical acceptance criteria of these external evaluation items. Besides, the external predictive performances of most models were unsatisfactory in prediction- and simulation-based diagnostics. Nevertheless, the application of Bayesian forecasting significantly improved the predictive performance, even with only one prior observation. CONCLUSIONS: Two models that included the most covariates had the best predictive performance across all external assessments. Inclusion of different covariates, heterogeneity of preterm infant characteristics, and different study designs influenced predictive performance. Thorough evaluation is needed before these PopPK models can be implemented in clinical practice. The implementation of MIPD for caffeine in preterm infants could benefit from the combination of PopPK models and Bayesian forecasting as a helpful tool.

Global disparities in cancer supportive care: An international survey.

BACKGROUND: The global cancer burden is rising, particularly in low- and middle-income countries (LMIC), highlighting a critical research gap in understanding disparities in supportive care access. To address this, the Multinational Association of Supportive Care in Cancer (MASCC) Health Disparities Committee initiated a global survey to investigate and delineate these disparities. This study aims to explore and compare supportive care access disparities between LMIC and High-Income Countries (HIC). METHODS: An online cross-sectional survey was conducted among active members of MASCC. Members, representing diverse healthcare professions received email invitations. The survey, available for 3 weeks, comprised sections covering (1) sociodemographic information; (2) clinical service/practice-related disparities in their region/nation; (3) population groups facing disparities within their region or country. Chi-squared or Fisher's exact test for cross-sectional analyses, and a multivariable logistic regression model was employed for statistical analysis. RESULTS: A total of 218 active members participated, with one-quarter (26.6%) from LMIC and 18.4% ethnic minorities, timely cancer care (43.7%) and timely supportive care (45.0%) emerged as the most pressing disparities globally. Notably, participants from LMIC underscored cancer drug affordability (56.4%) and supportive care guideline implementation (56.4%) as critical issues. Economically disadvantaged populations were noted as more likely to face disparities by both LMIC and HIC (non-US-based) respondents, while US-based respondents identified racial/ethnic minorities as facing more disparities. CONCLUSION: This global survey reveals significant disparities in cancer supportive care between LMIC and HIC, with a particular emphasis on medication affordability and guideline implementation in LMIC. Addressing these disparities requires targeted intervention, considering specific regional priorities.

Development and application of a population pharmacokinetic model repository for caffeine dose tailoring in preterm infants.

BACKGROUND: Considerable interindividual variability for the pharmacokinetics of caffeine in preterm infants has been demonstrated, emphasizing the importance of personalized dosing. This study aimed to develop and apply a repository of currently published population pharmacokinetic (PopPK) models of caffeine in preterm infants to facilitate model-informed precision dosing (MIPD). RESEARCH DESIGN AND METHODS: Literature search was conducted using PubMed, Embase, Scopus, and Web of Science databases. Relevant publications were screened, and their quality was assessed. PopPK models were reestablished to develop the model repository. Covariate effects were evaluated and the concentration-time profiles were simulated. An online simulation and calculation tool was developed as an instance. RESULTS: Twelve PopPK models were finally included in the repository. Preterm infants' age and body size, especially the postnatal age and current weight, were identified as the most clinically critical covariates. Simulated blood concentration-time profiles across these models were comparable. Caffeine citrate-dose regimen should be adjusted according to the age and body size of preterm infants. The developed online tool can be used to facilitate clinical decision-making. CONCLUSIONS: The first developed repository of PopPK models for caffeine in preterm infants has a wide range of potential applications in the MIPD of caffeine.

[Comparison of the efficacy of LARS ligament and autogenous hamstring tendon plus high-strength suture in posterior cruciate ligament reconstruction].

OBJECTIVE: To compare the clinical efficacy of ligament advanced reinforcement system (LARS) and autogenous hamstring tendon plus high-strength suture in arthroscopic reconstruction of posterior cruciate ligament(PCL). METHODS: A total of 96 patients with simple PCL injury treated with arthroscopic posterior cruciate ligament reconstructive surgery admitted to our hospital between August 2019 and December 2021 were selected for complete follow-up. There were 78 males and 18 females, 40 cases of left leg and 56 cases of right leg, the aged from 20 to 56 years old with an average of (32.50±8.68 ) years old. The transplants were divided into two groups:LARS group (52 cases) and autogenous hamstring tendon plus high-strength suture group (44 cases). In the LARS group, there were 42 males and 10 females;with an average age of (31.84±8.62) years old;body mass index (BMI) was (24.73±2.29) kg﹒m-2;7 mm LARS was used to reconstruct PCL. In the autologous tendon group, there were 36 males and 8 females, with an average age of (33.06±8.99) years old, BMI was (23.52±2.16) kg·m-2, and the PCL was reconstructed with four strands of hamstring tendons and three pieces of Ethibond suture. All patients underwent functional rehabilitation guided exercise and were followed up regularly after surgery to objectively evaluate the stability of the knee joint by KT-1000 measurement of knee relaxation, and subjective evaluation of knee function by Lysholm score, Tegner score, and International Knee Documentation Council (IKDC) score. Data from preoperative, 3, 6, and 12 month follow-up were collected and analyzed by SPSS software to compare postoperative recovery and ligament relaxation between the two groups of patients. RESULTS: Ninety-six patients were followed up for 12 months. KT-1000 measurement of knee joint in autogenous tendon group and LARS group before operation [(10.73±1.46) points vs (10.55±1.53) points], 6 months after operation[(3.02±0.75) points vs (2.35±0.60) points], 12 months after operation[(3.77±1.76) points vs (2.44±0.60) points]. There was significant difference between the two groups at 6 and 12 months after operation (P<0.05), but there was no significant difference between the two groups at 3 months after operation (P>0.05). In the autogenous tendon group and LARS group, before operation and 12 months after operation, total Lysholm score [(40.6±16.8), (91.25±6.35) points vs (51.92±18.52), (92.35±5.30) points], Tegner score[(1.8±0.7), (5.8±0.6) points vs(1.7±0.8)、(5.7±0.7) points] and total IKDC score[(54.50±6.33), (83.90±3.93) points vs (54.40±4.24), (83.62±3.64) points], the differences were statistically significant (P<0.05), indicating that the knee function of the two groups was improved after surgery. At 3 and 6 months after operation in the autogenous tendon group and LARS group, the total Lysholm score[(65.86±11.54), (74.60±6.46) points vs (73.46±6.42), (86.73±4.62) points], Tegner score[(2.5±0.6), (3.5±0.5) points vs (4.3±0.7), (5.0±1.4) points], the total scores of IKDC [(55.78±2.68), (70.62±4.74) points vs (65.31±4.60), (79.71±2.93) points]. The difference between two groups was statistically significant (P<0.05). The results showed that the function of the knee joint in the LARS group was better than that the autologous tendon group. However, at 12 months after the operation, there was no significant difference in the score of knee joint function between the two groups (P>0.05). The results showed that the stability of LARS group was better than that of autologous tendon group. CONCLUSION: Both the autogenous hamstring tendon plus high-strength suture and LARS reconstruction can significantly improve the knee function and stability, with satisfactory postoperative results. Howervr the LARS provides superior postoperative stability.

Tetracycline Three Times Daily Versus Four Times Daily in Bismuth-Containing Quadruple Therapy as the First-Line Treatment of Helicobacter pylori Infection: A Multicenter, Noninferiority, Randomized Controlled Trial.

BACKGROUND: Current guidelines recommend bismuth-containing quadruple therapy for patients newly diagnosed with Helicobacter pylori (H. pylori) infection. We aimed to compare the efficacy and safety of tetracycline administered three times daily versus four times daily in bismuth-containing quadruple therapy for first-line treatment of H. pylori infection. METHODS: This multicenter, noninferiority, randomized controlled study, conducted in China, recruited treatment-naïve adults with H. pylori infection, randomized 1:1 into two treatment groups to receive either of the following bismuth-containing quadruple therapies: esomeprazole 20 mg twice-daily; bismuth 220 mg twice-daily; amoxicillin 1000 mg twice-daily; and tetracycline 500 mg three times daily (TET-T) versus 500 mg four times daily (TET-F). At least 6 weeks post-treatment, a 13C-urea breath test was performed to evaluate H. pylori eradication. RESULTS: In total, 406 patients were randomly assigned to the two treatment groups. Intention-to-treat eradication rates were 91.63% (186/203; 95% confidence interval [CI] 87.82%-95.44%) versus 90.15% (183/203; 95% CI 86.05%-94.25%) (p = 0.0005) and per-protocol eradication rates were 95.34% (184/193; 95% CI 92.36%-98.31%) versus 95.72% (179/187; 95% CI 92.82%-98.62%) (p = 0.0002) for the TET-T and TET-F group, respectively. TET-T-treated patients had a lower incidence of adverse effects than TET-F-treated patients (21.61% vs. 31.63%, p = 0.024), with no significant differences in compliance to treatment between the groups. CONCLUSION: As a first-line therapy for H. pylori infection, the eradication rate of the TET-T therapy was noninferior to that of the TET-F therapy while significantly reducing the incidence of adverse reactions. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT05431075.

CD38 deficiency prevents diabetic nephropathy by inhibiting lipid accumulation and oxidative stress through activation of the SIRT3 pathway.

Diabetic nephropathy (DN) is one of the most common complications of diabetes. Our previous study showed that CD38 knockout (CD38KO) mice had protective effects on many diseases. However, the roles and mechanisms of CD38 in DN remain unknown. Here, DN mice were generated by HFD feeding plus streptozotocin (STZ) injection in male CD38KO and CD38flox mice. Mesangial cells (SV40 MES 13 cells) were used to mimic the injury of DN with palmitic acid (PA) treatment in vitro. Our results showed that CD38 expression was significantly increased in kidney of diabetic CD38flox mice and SV40 MES 13 cells treated with PA. CD38KO mice were significantly resistant to diabetes-induced renal injury. Moreover, CD38 deficiency markedly decreased HFD/STZ-induced lipid accumulation, fibrosis and oxidative stress in kidney tissue. In contrast, overexpression of CD38 aggravated PA-induced lipid accumulation and oxidative stress. CD38 deficiency increased expression of SIRT3, while overexpression of CD38 decreased its expression. More importantly, 3-TYP, an inhibitor of SIRT3, significantly enhanced PA-induced lipid accumulation and oxidative stress in CD38 overexpressing cell lines. In conclusion, our results demonstrated that CD38 deficiency prevented DN by inhibiting lipid accumulation and oxidative stress through activation of the SIRT3 pathway.

Synthesis of Bridged Five-Membered Ring Systems by Type II [3 + 2] Annulation of Allenylsilane-ene.

The first type II intramolecular [3 + 2] annulation of allenylsilane-ene has been achieved, enabling diastereoselective and efficient construction of synthetically challenging bridged five-membered ring systems such as bicyclo[3.2.1]. This mild and direct process shows a broad substrate scope and is highly stereospecific. Particularly, this work represents the first stereoselective method for the direct synthesis of bicyclo[3.2.1] ring systems from acyclic precursors. Additionally, the first asymmetric total syntheses of (+)- and (-)-strepsesquitriol, and the efficient formation of the synthetically challenging tetracyclic core of pierisjaponol D are achieved by this type II [3 + 2] annulation reaction.

First Report of Colletotrichum queenslandicum Causing Leaf Anthracnose on Jatropha curcas L in China.

Jatropha curcas L. (Euphorbiaceae), is a valuable multi-purpose crop, previously used for disease treatment and environmental restoration, recently is attention to use jatropha oil for produce biodiese. In June 2023, the leaf disease of approximately 60% of J. curcas was observed in Mazhang, Zhanjiang, Guangdong Province (E110°27'26.8'' N22°6'14.7''). Diseased leaves showed typical anthracnose symptoms of chlorotic regions with brownish sunken necrotic lesions (Figure 1). Sections from the junction of disease were surface disinfected in 75% ethanol and 3% hydrogen peroxide solution for 1 minute each. Four small pieces of infected tissue were removed from the lesion and placed on potato dextrose agar (PDA), and incubated at 25 to 28℃ in the dark. Hyphal tips from the inoculated tissues were subcultured on PDA and two isolates were purified by single spore method. The colonies on PDA were 7.8 cm diam after 10 d at 25 to 28 ℃, covered with dense, cottony, grayish-white aerial mycelium and small dark-based acervuli with orange ooze and dark brown straight setae. Conidia were hyaline, smooth-walled, aseptate, the apex and base rounded, slightly constricted near centre, 12.9 - 13.8 × 3.9 - 4.6 um (av.13.6 × 4.3 µm, n = 50). Appressoria were variable in shape, mostly simple, subglobose or irregular lobes, 5.8-9.6 × 5.7-11.2 um (Figure 2). Perithecia were not observed. These characteristics were consistent with Colletotrichum sp. (Weir, B. S., et al. 2012). Sequences of isolates ACCC 35630 and ACCC 35631 stored in Agricultural Culture Collection of China including internal transcribed spacer (ITS), actin (ACT), beta-tubulin (tub2), glyceraldehyde-3-phosphate dehydrogenase (GAPDH) and chitin synthase (chs). were amplified (Weir et al, 2012), sequenced and submitted to GenBank (ITS: PP474979 and PP474984; ACT: PP505487 and PP505488; TUB: PP505493 and PP505494; GAPDH: PP505491 and PP505492; CHS: PP505489 and PP505490). The amplicon sizes of ITS, ACT, TUB, GAPDH, and CHS were 550, 652, 500, 264, and 301 bp, respectively. Phylogenetic analyses showed that Isolates 35630 & 35631 were clustered closely association with RHCOL1 and RHCOL3. Phylogenetic analysis with MEGA 7 using the combined ITS-ACT-CHS-GAPDH-TUB2 sequences showed that the two isolates clustered with C. queenslandicum (Figure 3). To test the pathogenicity, ten healthy leaves on plants in the field were wiped with 75% alcohol and sterile water, punctured with a sterile needle and inoculated by adding 10 uL of spore suspension (1 × 105 conidia/ml) to the wounded sites. And two other leaves were added sterile water as controls. Symptoms of anthracnose were observed on leaves similar to the disease described above after 7 days of inoculation, whereas the leaves from the controls remained asymptomatic. C. queenslandicum was reisolated from the inoculated leaves. C. queenslandicum has been reported as a pathogen causing leaf and fruit anthracnose on papaya, coffee, rambutan, avocado and Persian lime etc. in tropical and temperate regions (Kunta, M., et al. 2018), and this is the first report on J. curcas in China as well as worldwide. This disease may have a significant negative impact on J. curcas cultivation.

Exploring usage pattern variation of free-floating bike-sharing from a night travel perspective.

Free-floating bike sharing (FFBS) attracts increasing research focusing on usage patterns, determining factors, and integrated transportation. However, existing researchers tend to overlook the variation in usage characteristics over various time ranges, particularly the usage pattern at night. This paper is conducted to fill the gap through a series of analysis approaches on FFSB in Beijing. The characteristics of the usage pattern, including time-varying usage and traveling distance distributions, are initially illustrated. Subsequently, the spatial patterns of FFBS are visualized and thoroughly analyzed in different time ranges and origin-destination (O-D) flows. A statistical model evaluating the environmental effects of FFBS trips revealed the source of FFBS usage. In addition to focusing on the nighttime, the usage patterns varying day and night are compared through the analysis. The findings explain the usage pattern variation and the unique pattern at night, providing valuable insight for improving the management of the FFBS system.

Financial Toxicity in Cancer Supportive Care: An International Survey.

PURPOSE: The study aims to explore unmet social needs and sources of financial toxicities in patients as noted by health care professionals and researchers in cancer supportive care, shedding light on potential health disparities. METHODS: In this cross-sectional survey, we anonymously surveyed active members of the Multinational Association of Supportive Care in Cancer (MASCC). The survey, structured in three sections, included questions regarding the routine assessment of social needs during patient consultations, sociodemographic aspects, factors influencing financial toxicity (FT), perceived support for managing FT, and available/desirable resources. RESULTS: A total of 218 MASCC members were included, predominantly from high-income countries (HIC, 73.4%), with many age 41-60 years (56.5%) and female (56.9%). Drug/treatment cost and insurance coverage were the main sources for FT among the HIC, whereas participants from low-middle-income countries (LMIC) considered transportation cost, loss of employment because of cancer diagnosis, and unavailability of return-to-work services as the top three sources of FT. Respondents from LMIC (adjusted odds ratio [aOR], 3.01 [95% CI, 1.15 to 7.93]) and physicians (aOR, 2.67 [95% CI, 1.15 to 6.21]) were more likely to routinely assess financial coverages. Socioeconomic status was consistently ranked as one of the top three sources of financial toxicities by participants from LMIC (34%), HIC excluding the United States (38%), those who do not self-identify as racial/ethnic minority (36%), and physicians (40%). CONCLUSION: This global survey of health care professionals and researchers in HIC and LMIC revealed varying approaches to assessing financial coverage and social needs. Socioeconomic status emerged as a consistent concern across countries, affecting financial toxicities. The study highlights the need for tailored approaches and improved resource visibility while emphasizing clinicians' pivotal role in addressing financial aspects of cancer care.

Feasibility of Weekly Integrated Palliative Care Outcome Scale (IPOS) Within a Stepped Care Model.

CONTEXT: Patients with advanced cancer may experience symptoms and concerns that are inadequately identified by the healthcare team, leading to calls for patient-reported symptom monitoring. OBJECTIVES: Assess the feasibility of administering weekly patient-reported online Integrated Palliative care Outcome Scale (IPOS) questionnaires within the context of a stepped care model in the outpatient care setting. METHODS: Analysis of intervention group data in a randomized controlled trial to assess the effectiveness of a stepped care model of palliative care for patients with advanced cancer. Patients in the intervention group were invited to complete the IPOS weekly for 16 weeks through a remotely-administered online questionnaire. At the end of the 16-week period, patients were invited to complete a feedback survey. Multivariable logistic regression was used to assess factors associated with more versus less than 70% completion of weekly questionnaires. RESULTS: Among 111 patients who survived more than 16 weeks, the mean number of questionnaires completed was 9.2/16 (58%). A total of 53 out of the 111 patients (48%) completed more than 70% of the questionnaires. Higher education level was found to be associated with higher completion of the questionnaires. A total of 79 out of 111 (71%) patients responded to the feedback survey, of which 67 (85%) felt comfortable with completing the online questionnaire and 11 (14%) felt it was troublesome to complete it on a weekly basis. CONCLUSION: In our study, there was suboptimal completion of patient-reported IPOS questionnaire. Further research is needed to improve the uptake of patient-reported outcomes in real-world clinical settings.

Impact of a Multidisciplinary Supportive Care Model Using Distress Screening at an Asian Ambulatory Cancer Center: A Cluster Randomized Controlled Trial.

PURPOSE: The Accessible Cancer Care to Enable Support for Cancer Survivors (ACCESS) program adopts a multidisciplinary supportive care model with routine distress screening to triage newly diagnosed cancer survivors for additional support on the basis of distress levels. This study aimed to evaluate the clinical impact of ACCESS over 1 year. METHODS: We performed cluster random assignment at the oncologist level in a 1:1 ratio to receive ACCESS or usual care. Participants 21 years and older, newly diagnosed with breast or gynecologic cancer, and receiving care at National Cancer Centre Singapore were included. Outcomes assessed every 3 months for 1 year included quality of life (QoL) (primary), functioning, physical and psychological symptom burden, and activity levels. Data were analyzed using mixed-effects models. RESULTS: Participants from 16 clusters (control = 90, intervention = 83) were analyzed. The ACCESS program did not significantly improve QoL (primary outcome). However, compared with usual care recipients, ACCESS recipients reported higher physical functioning (P = .017), role functioning (P = .001), and activity levels (P < .001) at 9 months and lower psychological distress (P = .025) at 12 months. ACCESS recipients screened with high distress had poorer QoL, lower role and social functioning, and higher physical symptom distress at 3 months but had comparable scores with ACCESS recipients without high distress after 12 months. CONCLUSION: Compared with usual care, participation in the ACCESS program did not yield QoL improvement but showed earlier functioning recovery related to activities of daily living and reduced psychological distress. Routine distress screening is a promising mechanism to identify survivors with poorer health for more intensive supportive care.

Neoscytalidium dimidiatum causing stem canker on Hylocereus megalanthus in China.

Hylocereus megalanthus (syn. Selenecereus megalanthus), commonly known as Yanwo fruit (bird's nest fruit), is an important tropical fruit, which is popular and widely planted due to its high nutritional and economic value in southern China. In September 2022, a serious stem and fruit canker was observed on Ecuadorian variety of Yanwo fruit plant in a 0.2 ha orchard in Guangdong (N21°19'1.24" E110°7'28.49"). Almost all plants were infected and disease incidence of fruits and stems was about 80% and 90% respectively. Symptoms on the stem and fruits were small, circular or irregular, sunken, orangish brown spots that developed into cankers (Fig 1 A, B and C). Black pycnidia were embedded under the surface of the cankers at the initial stage, subsequently they became erumpent from the surface, and the infected parts rotted. Five symptomatic stems from five plants were collected, 0.2 cm2 tissues adjacent to cankers were surface sterilized and placed on potato dextrose agar (PDA) to incubate at 25 to 28 ℃. Fungal isolates each with similar morphology grew from 100% of the tissues. Colonies covered with aerial mycelium were grayish white, and then gradually turned to grayish black. Septate hyphae were hyaline to brown and constricted into arthroconidial chains. The arthroconidia were variously shaped and colored, orbicular to rectangular, hyaline to dark brown, thick-walled, and zero- to one- septate, averaging 7.7 × 3.6 µm (n>50) (Fig 1 D, E, F and G). To identify the fungus, the internal transcribed spacer region (ITS), translation elongation factor 1-alpha (tef1), beta-tubulin (tub2), histone H3 (his3) and chitin synthase (chs) gene of isolate ACCC 35488 and ACCC 35489 (Agricultural Culture Collection of China) were amplified and sequenced with primer pairs: ITS1/ITS4 (White et al. 1990), EF1-728F/EF2-rd (Carbone & Kohn 1999; O'Donnell et al.1998), TUB2Fd/ TUB4Rd（Aveskamp et al 2009）, CYLH3F/H3-1b (Crous et al. 2004) and CHS-79F/CHS-345R (Carbone & Kohn 1999) (ITS: OQ381102 and PP488350; tef1: OQ408545 and PP510454; tub2: OQ408546 and PP510455; his3: OQ408544 and PP510453; chs: OQ408543 and PP510452). Sequence Blastn results showed above 99% identical with those of Neoscytalidium dimidiatum ex-type strain CPC38666. Phylogenetic tree inferred from Maximum Likelihood analysis of the combined ITS, tub2 and tef1 sequences revealed two isolates clustered with N. dimidiatum (Fig 2). Pathogenicity was tested on healthy one-year-old cuttings and fruits of Ecuadorian variety at room temperature. Six sites were pin-pricked on each stem and fruit. Both wounded stems and fruits were inoculated with spore suspensions (106 spore/ml) and 6-mm fungal plugs respectively. Sterile water and agar were used as control. The test was repeated twice. Stems and fruits were enclosed in plastic boxes with 80% relative humidity. Symptoms described above were observed on inoculated stems and fruits at five days post inoculation (Fig 1 H and I). No symptoms developed on the controls. Neoscytaliudium dimidiatum was reisolated from the cankers with a frequency of 100% via morphological and molecular analysis. This is first report of stem and fruit canker caused by N. dimidiatum on H. megalanthus in China and this disease represents a serious risk of Yanwo fruit yield losses. This fungus is widespread occurring throughout the world causing diseases on a wide variety of plants. The finding will be helpful for its prevention and control.