Acute skin toxicity and self-management ability among Chinese breast cancer radiotherapy patients: a qualitative study.

OBJECTIVES: Radiation dermatitis is the most common reaction to radiotherapy, almost all breast cancer patients receive radiotherapy on an outpatient basis. Currently, there are no studies on the experience of radiation dermatitis and the ability to self-manage it. Therefore, we aimed to use qualitative approaches to gain a deeper understanding of the actual experiences and self-management ability in order to provide a reference for further improving the effectiveness of self-management and to optimize symptom management strategies. METHODS: A descriptive qualitative study was conducted using purposive sampling to select 17 breast cancer patients undergoing radiotherapy. Semi-structured interviews were conducted from September to November 2023. The Colaizzi seven-step analysis method was used to classify the data into summarized themes. RESULTS: Four themes were identified from the interview responses: (1) multiple self-reported skin symptoms in breast cancer patients with radiation dermatitis; (2) the multidimensional impact on patient's quality of life, especially pruritus, ulceration; (3) the ability to self-manage radiation dermatitis: strong mental toughness, positive response, and self-doubt; (4) challenges faced: concerns about radiotherapy side effects and recurrence, targeted symptom management and continuity of care after the radiotherapy. CONCLUSIONS: Healthcare professionals should consider patients' self-reported symptoms when assessing radiation dermatitis. For pruritus and pain, we can enhance precision symptom management to improve patients' quality of life. By utilizing information technology tools, we can increase breast cancer patients' ability and confidence in managing radiation dermatitis effectively while enhancing accurate symptom management during radiotherapy.

sp-Carbon-Conjugated Organic Polymer as Multifunctional Interfacial Layers for Ultra-Long Dendrite-Free Lithium Metal Batteries.

Fatal issues in lithium metal anodes (LMA), such as detrimental lithium dendrites growth and fragile solid-electrolyte interphase (SEI) during the Li plating/stripping process, often hinder the practical application of Li metal batteries (LMBs). Herein, cobalt-coordinated sp-carbon-conjugated organic polymer (Co-spc-COP) is constructed as the protective layer for regulating the interface stability of LMA. The unique synergistic beneficial effect of organic functional groups (C≡C linkage, C=N units and aromatic rings) and Co sites not only regulate the Li+ coordination environment and rearrange Li+ concentration to facilitate its transport by optimizing the electronic density, enhancing the compatibility with electrolyte interface and supplying "external magnetic driving strategy", but also strengthens the interfacial stiffness with high Young's modulus to better withstand the mechanical stress. These beneficial effects and relative underlying working mode and mechanism of uniform Li plating and rapid Li+ migration on the Co-spc-COP are also revealed by various in situ/ex situ experimental technologies and theory calculation. The Co-spc-COP-based cell delivers an extraordinary lifespan of 6600 h and ultrahigh capacity retention of 78.3 % (111.9 mAh g-1) after 1000 cycles at 1 C. This demonstrated synergistic strategy in Co-coordinated organic polymer may gain new insights to regulate the uniform and non-dendritic deposition/dissolution behaviors for highly stable LMBs.

High-Entropy MXene as Bifunctional Mediator toward Advanced Li-S Full Batteries.

The development of high-energy-density Li-S batteries (LSBs) is still hindered by the disturbing polysulfide shuttle effect. Herein, with clever combination between "high entropy" and MXene, an HE-MXene doped graphene composite containing multiple element quasi-atoms as bifunctional mediator for separator modification (HE-MXene/G@PP) in LSBs is proposed. The HE-MXene/G@PP offers high electrical conductivity for fast lithium polysulfide (LiPS) redox conversion kinetics, abundant metal active sites for efficient chemisorption with LiPSs, and strong lipophilic characteristics for uniform Li+ deposition on lithium metal surface. As demonstrated by DFT theoretical calculations, in situ Raman, and DRT results successively, HE-MXene/G@PP efficiently captures LiPSs through synergistic modulation of the cocktail effect and accelerates the LiPSs redox reaction, and the lattice distortion effect effectively induces the homogeneous deposition of dendritic-free lithium. Therefore, this work achieves excellent long-term cycling performance with a decay rate of 0.026%/0.031% per cycle after 1200 cycles at 1 C/2 C. The Li||Li symmetric cell still maintains a stable overpotential after 6000 h under 40 mA cm-2/40 mAh cm-2. Furthermore, it delivers favorable cycling stability under 7.8 mg cm-2 and a low E/S ratio of 5.6 µL mg-1. This strategy provides a rational approach to resolve the sulfur cathode and lithium anode problems simultaneously.

A Metal-Organic Framework-Derived Strategy for Constructing Synergistic N-Doped Carbon-Encapsulated NiCoP@N-C-Based Anodes toward High-Efficient Lithium Storage.

Transition metal phosphides (TMPs) have been regarded as the prospective anodes for lithium-ion batteries (LIBs). However, their poor intrinsic conductivity and inevitable large volume variation result in sluggish redox kinetics and the collapse of electrode structure during cycling, which substantially hinders their practical use. Herein, an effective composite electrodes design strategy of "assembly and phosphorization" is proposed to construct synergistic N-doped carbon-encapsulated NiCoP@N-C-based composites, employing a metal-organic frameworks (MOFs) as sacrificial hosts. Serving as the anodes for LIBs, one representative P-NCP-NC-600 electrode exhibits high reversible capacity (858.5 mAh g-1, 120 cycles at 0.1 A g-1) and superior long-cycle stability (608.7 mAh g-1, 500 cycles at 1 A g-1). The impressive performances are credited to the synergistic effect between its unique composite structure, electronic properties and ideal composition, which achieve plentiful lithium storage sites and reinforce the structural architecture. By accompanying experimental investigations with theoretical calculations, a deep understanding in the lithium storage mechanism is achieved. Furthermore, it is revealed that a more ideal synergistic effect between NiCoP components and N-doped carbon frameworks is fundamentally responsible for the realization of superb lithium storage properties. This strategy proposes certain instructive significance toward designable high-performance TMP-based anodes for high-energy density LIBs.

Ultra-Sleek High Entropy Alloy Tights: Realizing Superior Cyclability for Anode-Free Battery.

The development of Li-free anodes to inhibit Li dendrite formation and provide high energy density Li batteries is highly applauded. However, the lithiophobic interphase and heterogeneous Li deposition hindered the practical application. In this work, a 20 nm ultra-sleek high entropy alloy (HEA, NiCdCuInZn) tights loaded with HEA nanoparticles are developed by a thermodynamically driven phase transition method on the carbon fiber (HEA/C). Multiple Li+ transport paths and abundant active sites are enabled by the cocktail effect of different constituent elements in HEA. These active sites with gradient absorption energies (-3.18 to -2.03 eV) facilitate selective binding, providing a low barrier for homogeneous Li nucleation. Simultaneously, multiple transport paths promote Li diffusion behavior with uniform Li deposition. Thus, the HEA/C achieves high reversibility of Li plating/stripping processes over 2000 cycles with a coulombic efficiency of 99.6% at 5 mA cm-2 /1 mAh cm-2 in asymmetric cells, as well as over 7200 h at 60 mA cm-2 /60 mAh cm-2 in symmetric cells. Moreover, the anode-free full cell with the HEA/C host has an average coulombic efficiency of 99.5% at 1 C after 160 cycles. This advanced HEA structure design shows a favorable potential application for anode-free Li metal batteries.

Assessment of the anti-inflammatory mechanism of quercetin 3,7-dirhamnoside using an integrated pharmacology strategy.

Pouzolzia zeylanica (L.) Benn. is a Chinese herbal medicine widely used for its anti-inflammatory and pus-removal properties. To explore its potential anti-inflammatory mechanism, quercetin 3,7-dirhamnoside (QDR), the main flavonoid component of P. zeylanica (L.) Benn., was extracted and purified. The potential anti-inflammatory targets of QDR were predicted using network analysis. These potential targets were verified using molecular docking, molecular dynamics simulations, and in vitro experiments. Consequently, 342 potential anti-inflammatory QDR targets were identified. By analyzing the intersection between the protein-protein interaction and the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways, we identified several potential protein targets of QDR, including RAC-alpha serine/threonine-protein kinase (AKT1), Ras-related C3 botulinum toxin substrate 1 (RAC1), nitric oxide synthase 3 (NOS3), serine/threonine-protein kinase mTOR (mTOR), epidermal growth factor receptor (EGFR), growth factor receptor-bound protein 2 (GRB2), and endothelin-1 receptor (EDNRA). QDR has anti-inflammatory activity and regulates immune responses and apoptosis through chemokines, Phosphatidylinositol 3-kinase 3(PI3K)/AKT, cAMP, T-cell receptor, and Ras signaling pathways. Molecular docking analysis showed that QDR has good binding abilities with AKT1, mTOR, and NOS3. In addition, molecular dynamics simulations demonstrated that the protein-ligand complex systems formed between QDR and AKT1, mTOR, and NOS3 have high dynamic stability, and their protein-ligand complex systems possess strong binding ability. In RAW264.7 macrophages, QDR significantly inhibited lipopolysaccharides (LPS)-induced inducible nitric oxide synthase expression, nitric oxide (NO) release and the generation of proinflammatory cytokines IL-6, IL-1ß, and TNF-α. QDR downregulated the expression of p-AKT1(Ser473)/AKT1 and p-mTOR (Ser2448)/mTOR, and upregulated the expression of NOS3, Rictor, and Raptor. This indicates that the anti-inflammatory mechanisms of QDR involve regulation of AKT1 and mTOR to prevent apoptosis and of NOS3 which leads to the release of endothelial NO. Thus, our study elucidated the potential anti-inflammatory mechanism of QDR, the main flavonoid found in P. zeylanica (L.) Benn.

Targeted co-delivery of resiquimod and a SIRPα variant by liposomes to activate macrophage immune responses for tumor immunotherapy.

Tumor-associated macrophages (TAMs) are the major immune cells infiltrating the tumor microenvironment (TME) and typically exhibit an immunosuppressive M2-like phenotype, which facilitates tumor growth and promotes resistance to immunotherapy. Additionally, tumor cells tend to express high levels of CD47, a "don't eat me" signal, that obstructs macrophage phagocytosis. Consequently, re-educating TAMs in combination with CD47 blockage is promising to trigger intense macrophage immune responses against tumors. As a toll-like receptor 7/8 agonist, resiquimod (R848) possesses the capacity to re-educate TAMs from M2 type to M1 type. We found that intratumoral administration of R848 synergistically improved the antitumor immunotherapeutic effect of CV1 protein (a SIRPα variant with high antagonism to CD47). However, the poor bioavailability and potential toxicity of this combo strategy remain a challenge. Here, a TAMs-targeted liposome (named: R-LS/M/CV1) co-delivering R848 and CV1 protein was constructed via decorating mannose on the liposomal surface. R-LS/M/CV1 exhibited high abilities of targeting, re-education and pro-phagocytosis of tumor cells to M2 macrophages in vitro. Intratumoral administration of R-LS/M/CV1 remarkedly eliminated tumor burden in the MC38 tumor model via repolarization of TAMs to M1 type, pro-phagocytosis of TAMs against tumors, and recruitment of tumor-infiltrating T cells. More encouragingly, due to the double targeting to TAMs and tumor cells of mannose and CV1 protein, R-LS/M/CV1 effectively accumulated at the tumor site, thereby not only remarkedly inhibiting tumors, but also exerting no hematological and histopathological toxicity when administered systemically. Our integrated strategy based on re-educating TAMs and CD47 blockade provides a promising approach to trigger macrophage immune responses against tumors for immunotherapy.

Survival analysis of a comprehensive treatment strategy for internal carotid artery blowout syndrome by nasopharyngeal carcinoma.

OBJECTIVE: To retrospectively analyze the comprehensive treatment strategy for internal carotid artery blowout syndrome (CBS) by nasopharyngeal carcinoma (NPC). METHODS: Of the 311 patients of NPC with carotid artery blowout syndrome admitted at our center from April 2018 to August 2022, 288 were enrolled. RESULTS: The patients were divided into two groups: treatment group (266 cases) and control group (22 cases). After comprehensive treatment, the survival rate of the treatment group was significantly higher than that of the control group, especially within 6 months to the 1 year. Preventive intervention for CBS I type may have considerable benefits. And in the long run, this treatment strategy did not significantly increase the incidence of stroke in the treatment group. CONCLUSION: The comprehensive treatment strategy for ICA-CBS of patients with NPC significantly reduced the mortality of asphyxia due to epistaxis, reduced the incidence of CBS during nasal endoscopy, and finally improved survival rate.

Soy Protein/Polyvinyl-Alcohol (PVA)-Based Packaging Films Reinforced by Nano-TiO2.

This work was investigated to prepare a reinforcing composite packaging film composited of soy protein/polyvinyl alcohol (PVA) and nano-TiO2. First, different film compositions were designed by the particle size of nano-TiO2, concentration of nano-TiO2, concentration of polyvinylpyrrolidone (PVP, a dispersing agent for nano-TiO2), and pH of film casting solution. Then, the film composition that yielded the optimal physical properties was identified using orthogonal array design single-factor experiments, considering its physical properties, including tensile strength, elongation, water absorption, water vapor transmission, oxygen permeation, thermal property, and film morphology. The results displayed that the optimal film composition was (1) soy protein/PVA film with 2.5 wt% nano-TiO2, (2) 30 nm nano-TiO2 particle size, (3) 1.5 wt% PVP, and (4) pH 6.0 of film-forming solution. It yielded tensile strength of 6.77 MPa, elongation at break rate of 58.91%, and water absorption of 44.89%. Last, the films were characterized by scanning electron microscope (SEM) and differential scanning calorimetry (DSC). SEM analysis showed that compared with the film without TiO2, the film containing TiO2 has a smoother surface, and DSC determined that adding nano-TiO2 can improve the thermostability of soy protein/PVA film. Therefore, the film prepared in this paper is expected to provide a new theoretical basis for use in the packaging industry.

Recent Progress for Concurrent Realization of Shuttle-Inhibition and Dendrite-Free Lithium-Sulfur Batteries.

Lithium-sulfur (Li-S) batteries have become one of the most promising new-generation energy storage systems owing to their ultrahigh energy density (2600 Wh kg-1 ), cost-effectiveness, and environmental friendliness. Nevertheless, their practical applications are seriously impeded by the shuttle effect of soluble lithium polysulfides (LiPSs), and the uncontrolled dendrite growth of metallic Li, which result in rapid capacity fading and battery safety problems. A systematic and comprehensive review of the cooperative combination effect and tackling the fundamental problems in terms of cathode and anode synchronously is still lacking. Herein, for the first time, the strategies for inhibiting shuttle behavior and dendrite-free Li-S batteries simultaneously are summarized and classified into three parts, including "two-in-one" S-cathode and Li-anode host materials toward Li-S full cell, "two birds with one stone" modified functional separators, and tailoring electrolyte for stabilizing sulfur and lithium electrodes. This review also emphasizes the fundamental Li-S chemistry mechanism and catalyst principles for improving electrochemical performance; advanced characterization technologies to monitor real-time LiPS evolution are also discussed in detail. The problems, perspectives, and challenges with respect to inhibiting the shuttle effect and dendrite growth issues as well as the practical application of Li-S batteries are also proposed.

The Antidepressant Effect of Deoiled Sunflower Seeds on Chronic Unpredictable Mild Stress in Mice Through Regulation of Microbiota-Gut-Brain Axis.

Objectives: Sunflower seeds provide tryptophan-rich proteins with the potential to protect against depression. Tryptophan is a precursor of serotonin and a substrate for the production of indole derivatives by gut microbiota. This study aimed to investigate the association between the depression-alleviating effects of deoiled and dechlorogenic sunflower seeds (DSFS) and regulation of gut microbiota. Materials and Methods: Male C57BL/6J mice were fed a diet comprising a source of soy protein (normal and model control), DSFS or whey protein concentrate (positive control) for 7 weeks, and chronic stress-induced depression was induced. Results: Feeding the DSFS diet prevented depression-like behaviors, intestinal barrier damage, elevated plasma corticosterone, and reduced hippocampal serotonin levels in mice. Meanwhile, Feeding the DSFS diet significantly altered the gut microbiota structure, characterized by elevated relative abundances of Ileibacterium valens, Ruminococcus flavefaciens, Clostridium scindens, and Olsenella massiliensis, which were inversely associated with depressive behaviors and markers of mucosal barrier damage. DSFS also altered the gut metabolite profile, prevented depression-induced gut L-tryptophan depletion, and upregulated its metabolite indoleacetaldehyde. Conclusion: Feeding the DSFS diet prevented depression in mice by remodeling the gut microbiota and bacterial tryptophan metabolism.

Preparation and Characterization of Yellow Peach Peel/Sodium Alginate/Glycerol Antioxidant Film Applicable for Oil Package.

This work was dedicated to improving the utilization rate of yellow peach peel (YPP), with the addition of sodium alginate (SA) and glycerol (G) to prepare a biodegradable antioxidant film. First, the formulation of the film was optimized via response surface methodology (RSM) combined with the multi-index comprehensive evaluation method, considering physical properties including tensile strength (TS), elongation at break (E%), water solution (WS) and light transmittance (T). The RSM results displayed the best process condition was 2.50% of YPP, 0.60% SA and 0.80% of G (based on water) and compared with pure YPP film and YPP-SA film, the optimized (YPP-SA-G) film presented excellent properties with TS of 21.52 MPa, E of 24.8%, T of 21.56% on 600 nm, and WS of 41.61%, the comprehensive evaluation score of the film was 0.700. Furthermore, the films were characterized by Fourier transform infrared (FTIR) spectroscopy, scanning electron microscope (SEM), X-ray diffraction (XRD), and thermogravimetric analysis (TGA). FTIR analysis showed the main interaction of hydrogen between YPP, SA and G make the film has excellent compatibility, and the SEM images displayed that the film was dense and compacted with a little roughness. In addition, the optimized film had excellent thermal stability, suggested by TGA and XRD showed that the film's crystal structure has been changed significantly when the SA and G were mixed in. The TPC and the ability of DPPH radical scavenging of the YPP-SA-G film was 17.68 mg·g-1 of GAE and 18.65%, then potential packaging applications were evaluated using soybean oil and the YPP-SA-G antioxidant film significantly decreased peroxide value (POV) to delay oil oxidation during storage. Therefore, the YPP-SA-G film is expected to provide a new theoretical basis for the use of food processing by-products and the packaging industry.

Household investment diversification amid Covid-19 pandemic: Evidence from Chinese investors.

This paper finds the degree of investor's investment diversification is found to be positively correlated with confirmed cases in the city where they live. This relationship is a result of stricter quarantine policy adopted by cities hit with more severe Covid-19 outbreak, which has led to increased time for investors to trade stocks and seek advisory. In addition, the employment of investors in these cities is often negatively affected. Therefore, they tend to hold a relatively pessimistic view on expectations of future income, and thus be more cautious and risk-averse in terms of investment decisions.

Efficiency of Gemini surfactant containing semi-rigid spacer as microbial corrosion inhibitor for carbon steel in simulated seawater.

SRB is one of the main bacteria causing marine microbial corrosion. In order to reduce the loss of microbial corrosion, a Gemini surfactant (12-B-12) containing semi-rigid spacer was used to investigate the anti-bacterial and anti-corrosion performances of carbon steel in simulated seawater by weight-loss test, electrochemical method and surface morphology analysis. The results showed that the inhibition efficiency of 0.01 mM 12-B-12 was as high as 98.3% after 30 days of incubation in simulated seawater with SRB, and the planktonic and sessile SRB on the carbon steel surface can be reduced to undetectable level. Quantum chemical calculation and molecular dynamics simulation were used to study the structure-activity relationship.

Findings in Chinese Patients With Parkinson's Disease: A Content Analysis From the SML Study.

Social media listening (SML) is a new process for obtaining information from social media platforms to generate insights into users' experiences and has been used to analyze discussions about a multitude of diseases. To understand Parkinson's disease patients' unmet needs and optimize communication between doctors and patients, social media listening was performed to investigate concerns in Chinese patients. A comprehensive search of publicly available social media platforms with Chinese-language content posted between January 2005 and April 2019 in mainland China was performed using defined Parkinson's disease-related terms. After multiple steps of machine screening were performed, a series of posts were derived. The content was summarized and classified manually to analyze and map psychological insights, and descriptive statistics were applied to aggregate findings. A total of 101,899 patient-related posts formed the basis of this study. The topics mainly focused on motor symptoms (n = 54,983), choice of pharmaceutical drugs (n = 45,203) and non-motor symptoms (n = 44,855). The most common symptoms mentioned were tremor (54.5%), pain (22.9%), and rigidity (22.1%). Psychological burden (51%) and work/social burden (48%) were the most concerning burdens for patients and their families. The compound levodopa (43%) and dopamine agonists (23%) were the most common options for the patients, while concerns about new-generation anti-Parkinson's disease medication increased. The portraits of patients suggested varying characteristics across different periods and advocate for personalized service from doctors. In the management of patients, it is imperative to plan individualized therapy and education strategies as well as strategies for social support.

Deoiled sunflower seeds ameliorate depression by promoting the production of monoamine neurotransmitters and inhibiting oxidative stress.

We aimed to evaluate the antidepressant activity of deoiled sunflower seeds (SFS), which are rich in tryptophan, in our mouse model and explored a possible mechanism of action. Male C57BL/6J mice were subjected to chronic unpredictable mild stress (CUMS) and were administered a diet containing SFS as the main protein source. SFS alleviated CUMS-induced depression-like behaviors, compared to the effects of a whey protein-based diet. This effect was related to increases in the levels of serotonin, dopamine, norepinephrine, acetylcholine, and brain-derived neurotrophic factor in SFS-fed mice. These changes accompanied the amelioration of inflammatory abnormalities and oxidative stress. SFS increased the aromatic amino acid levels, and the ratio of tryptophan to neutral amino acids. Furthermore, the antidepressant-like effects of SFS were involved in lipid, nucleotide, and amino acid metabolism. In summary, SFS was found to attenuate depression-like symptoms in mice. These antidepressant effects may be related to the increase in the levels of aromatic amino acids and neurotransmitters, amelioration of oxidative stress and inflammation, and the regulation of the levels of abnormal metabolites to the normal levels.

Substrate-Independent, Reversible, and Easy-Release Ionogel Adhesives with High Bonding Strength.

It is highly desirable to develop reversible and easy-release adhesives with high bonding strength for a broad range of substrates, while the adhesion of low-surface-energy materials (e.g., polytetrafluoretyhylene, PTFE) is challenging. Herein, a substrate-independent ionogel adhesive is developed by blending an ionic liquid with the copolymer bearing charged segments. By regulating the viscoelastic properties of the ionogel, the adhesive and cohesive strength of the ionogel can be well balanced to maximize the bonding strength for different substrates. The as-developed ionogel exhibits high bonding strength (>0.3 MPa) for PTFE, plastics, metal, wood, and glass, because the variety of functional groups in the ionogel can form various supramolecular interactions with different substrates. The ionogel also exhibits reversible, easy-release, and reusable properties for multiple times of bonding and on-demand debonding without leaving obvious residues on the substrates. The ionogel has high potential for practical applications as temporal adhesives with high bonding strength.

Nanoparticle Tracking for Protein Aggregation Research.

Protein aggregates are the pathological agents in several neurodegenerative disorders such as Alzheimer's and Huntington's disease. In the pharmaceutical industry, protein aggregation poses significant challenges to the manufacture of biologics. Nanoparticle tracking is an emerging technology that allows particle-by-particle measurement of aggregate size and concentration. The technique is solution based, and requires no labeling. Here we describe protocols for using nanoparticle tracking in protein aggregation research, and provide a few examples for illustrative purposes.

Adsorption of tricresyl phosphate onto graphene nanomaterials from aqueous solution.

Phosphorus flame retardant tricresyl phosphate (TCP) adsorption on graphene nanomaterials from aqueous solutions was explored using batch and column modes. Comparative studies were performed regarding the kinetics and equilibrium of TCP adsorption on graphene oxide (GO) and graphene (G) in batch mode. The adsorption kinetics exhibited a rapid TCP uptake, and experimental data were well described by the pseudo-second-order kinetic model. Adsorption isotherm data of TCP on the two adsorbents displayed an improved TCP removal performance with increasing temperature at pH 5, while experimental data were well described by the Langmuir isotherm model with a maximum adsorption capacity of 87.7 mg·g-1 for G, and 30.7 mg·g-1 for GO) at 303 K. The thermodynamic parameters show that the adsorption reaction is a spontaneous and endothermic process. In addition, dynamic adsorption of TCP in a fixed G column confirmed a faster approach to breakthrough at high flow rate, high influent TCP concentration, and low filling height of adsorbent. Breakthrough data were successfully described by the Thomas and Yoon-Nelson models.

TANGO-Inspired Design of Anti-Amyloid Cyclic Peptides.

ß-Amyloid peptide (Aß) self-associates into oligomers and fibrils, in a process that is believed to directly lead to neuronal death in Alzheimer's disease. Compounds that bind to Aß, and inhibit fibrillogenesis and neurotoxicity, are of interest as an anti-Alzheimer therapeutic strategy. Peptides are particularly attractive for this purpose, because they have advantages over small molecules in their ability to disrupt protein-protein interactions, yet they are amenable to tuning of their properties through chemical means, unlike antibodies. Self-complementation and peptide library screening are two strategies that have been employed in the search for peptides that bind to Aß. We have taken a different approach, by designing Aß-binding peptides using transthyretin (TTR) as a template. Previously, we demonstrated that a cyclic peptide, with sequence derived from the known Aß-binding site on TTR, suppressed Aß aggregation into fibrils and protected neurons against Aß toxicity. Here, we searched for cyclic peptides with improved efficacy, by employing the algorithm TANGO, designed originally to identify amyloidogenic sequences in proteins. By using TANGO as a guide to predict the effect of sequence modifications on conformation and aggregation, we synthesized a significantly improved cyclic peptide. We demonstrate that the peptide, in binding to Aß, redirects Aß toward protease-sensitive, nonfibrillar aggregates. Cyclic peptides designed using this strategy have attractive solubility, specificity, and stability characteristics.