Acupuncture as Adjuvant Therapy for Glaucoma: Protocol for a Randomized Controlled Trial.

BACKGROUND: Glaucoma is a chronic progressive optic neuropathy that necessitates lifelong treatment to reduce the decline of the optic nerve. Due to the extended and continuous treatments required for patients, complementary therapies are often considered alongside conventional treatments to enhance the effectiveness of the treatment. Acupuncture has demonstrated the potential to lower intraocular pressure in previous clinical trials, making it a promising glaucoma intervention. OBJECTIVE: The primary objective of this study is to conduct a single-center randomized control trial involving patients with glaucoma. Acupuncture will be evaluated as an adjunctive therapy. The trial aims to explore its effectiveness for glaucoma. METHODS: In this single-center randomized controlled trial, participants (N=50) with primary open-angle glaucoma will be randomly assigned to the treatment group, receiving ophthalmic acupuncture with "De Qi" sensation, or the control group, receiving minimum acupuncture stimulation on nonophthalmic acupoints. The intervention will consist of weekly acupuncture treatments for a total of 6 sessions. Participants will be assessed at 8 time points, which are baseline, during the intervention (6 times), and at a 3-month follow-up. The primary outcome measure is a change in the intraocular pressure before and after each acupuncture treatment. Secondary outcomes will include measurements of heart rate and blood pressure before and after acupuncture, best-corrected visual acuity, visual field, optical coherence tomography, optical coherence tomography angiography, the Glaucoma Symptom Scale, and the Glaucoma Quality of Life-15 questionnaire. RESULTS: Recruitment of participants for the trial commenced on June 28, 2023. A total of 10 participants have been enrolled to test the feasibility of the experiment. We anticipate that the preliminary data from this trial will be completed by December 2025. CONCLUSIONS: This trial uses rigorous methodology and comprehensive outcome measurements to assess the clinical efficacy of acupuncture as an adjunctive therapy for glaucoma, providing valuable insights for future clinical treatment guidelines. TRIAL REGISTRATION: ClinicalTrials.gov NCT05753137; https://clinicaltrials.gov/study/NCT05753137. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/57888.

The activation of asparagine synthetase by the transcription factor FOXM1 plays a pivotal role in the initiation and progression of ESCC.

This study explores the role of the transcription factor FOXM1 in the initiation and progression of oesophageal squamous cell carcinoma (ESCC). Our findings reveal that FOXM1 is highly expressed in ESCC and correlates with the prognosis of the disease. The relationship between FOXM1 and asparagine synthetase (ASNS) is investigated, and the study demonstrates that FOXM1 activates ASNS, impacting the tumour stemness of ESCC. In this study, we reveal the association between FOXM1 and ESCC development, as well as FOXM1's promotion of migration and proliferation in ESCC cells. The study also highlights FOXM1's regulation of ASNS transcription and the functional role of ASNS in ESCC metastasis and growth. Furthermore, the study explores the impact of FOXM1 and ASNS on ESCC stemness and their potential implications for chemotherapy resistance.

Father support breastfeeding self-efficacy positively affects exclusive breastfeeding at 6 weeks postpartum and its influencing factors in Southeast China: a multi-centre, cross-sectional study.

BACKGROUND: The exclusive breastfeeding condition in China is not optimism now. Maternal breastfeeding self-efficacy stands as a pivotal factor influencing exclusive breastfeeding. Interestingly, studies have suggested that father support breastfeeding self-efficacy is a pivotal mediator in infant breastfeeding. Thus, the current research aimed to investigate the association between father support breastfeeding self-efficacy and exclusive breastfeeding at six weeks postpartum, and the influencing factors of father support breastfeeding self-efficacy. METHODS: This research was structured as a multi-centre cross-sectional study, involving 328 fathers, whose partners were six weeks postpartum, and recruited from two public hospitals in Southeast China. Self-designed demographic questionnaires, namely, Father Support Breastfeeding Self-Efficacy Scale-Short Form, Breastfeeding Knowledge Questionnaire, Positive Affect Scale and the 14-item Fatigue Scale, were applied. Descriptive statistics, Chi-square test, logistic regression univariate analysis and multiple linear regression were used to analyse data. RESULTS: Results indicate a significant difference between the infant feeding methods at six weeks postpartum and fathers with different levels of support breastfeeding self-efficacy (p < 0.05). Particularly, father support breastfeeding self-efficacy positively affected exclusive breastfeeding at six weeks postpartum after adjusting all the demographic characteristics of fathers (OR: 2.407; 95% CI: 1.017-4.121). Moreover, results show that the significant influencing factors of father support breastfeeding self-efficacy include breastfeeding knowledge, fatigue, positive affect, successfully experienced helping mothers to breastfeed, spousal relationships and companionship time. CONCLUSIONS: High-level father support breastfeeding self-efficacy effectively increased exclusive breastfeeding rate at six weeks postpartum. To enhance the exclusive breastfeeding rate, nurses or midwives can endeavour to design educational programmes or take supportive interventions customised for fathers, such as enhancing their breastfeeding knowledge education, reducing fatigue and mobilising positive emotions, thereby bolstering paternal self-efficacy in breastfeeding.

Role of hedgehog signaling in the pathogenesis and therapy of heterotopic ossification.

Heterotopic ossification (HO) is a pathological process that generates ectopic bone in soft tissues. Hedgehog signaling (Hh signaling) is a signaling pathway that plays an important role in embryonic development and involves three ligands: sonic hedgehog (Shh), Indian hedgehog (Ihh) and desert hedgehog (Dhh). Hh signaling also has an important role in skeletal development. This paper discusses the effects of Hh signaling on the process of HO formation and describes several signaling molecules that are involved in Hh-mediated processes: parathyroid Hormone-Related Protein (PTHrP) and Fkbp10 mediate the expression of Hh during chondrogenesic differentiation. Extracellular signal-regulated kinase (ERK), GNAs and Yes-Associated Protein (YAP) interact with Hh signaling to play a role in osteogenic differentiation. Runt-Related Transcription Factor 2 (Runx2), Mohawk gene (Mkx) and bone morphogenetic protein (BMP) mediate Hh signaling during both chondrogenic and osteogenic differentiation. This paper also discusses possible therapeutic options for HO, lists several Hh inhibitors and explores whether they could serve as emerging targets for the treatment of HO.

A comprehensive review of EGFR mutations abundance in non-small cell lung cancer treated with tyrosine kinase inhibitors.

BACKGROUND: Lung cancer is a major contributor to cancer-related death worldwide. Non-small cell lung cancer (NSCLC) accounts for approximately 85% of all lung cancers. Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) are currently viewed as the established first-line therapy for patients with advanced NSCLC with EGFR mutations. SUMMARY: The potential predictive value of the quantitative abundance of epidermal growth factor receptor (EGFR) mutations in the treatment of NSCLC is widely recognized and regarded as a significant indicator. The definition of mutation abundance in the EGFR gene in most current studies is mainly calculated based on the ratio of mutation to wild-type gene copy number or based on the ratio of allele number; for example, variant allele frequency (VAF) is the ratio of the number of mutant alleles to the total number of alleles at a particular locus. Results of the included primary studies: 1. Significant association between EGFR mutation abundance and PFS: Median PFS was significantly longer in the high abundance group (11.0 months, 95% CI: 9.7-12.3 months)) then in the low abundance group (5.3 months, 95% CI: 3.6-7.0 months) in the study by Liu et al. High mutation abundance (HR: 0.77, 95% CI: 0.66-0.82, P=0.037) was an independent prognostic determinant of PFS. in the study by wang et al. among patients receiving EGFR-TKI as first-line therapy; the median PFS was significantly longer in the high mutation abundance group than in the low mutation abundance group (12.7 months vs. 8.7 months, P=0.002). EGFR mutation abundance ≥30% was an independent risk factor for PFS (HR: 1.64, 95% CI: 1.17-2.31).2. Significant association between EGFR mutation abundance and OS: The median OS in the high abundance group in the study by Liu et al. was 20.9 months (95% CI: 18.3-23.5 months), while that in the low abundance group was 13.0 months (95% CI: 10.0 months). (95% CI: 10.3-15.7 months),longer OS was independently associated with high mutation abundance (HR: 0.62, 95% CI: 0.50-0.79, P=0.027). Key Messages: The objective of this article is to conduct a comprehensive examination and analysis of the association between the abundance of EGFR mutations in NSCLC and the effectiveness of treatment with TKIs while also considering the development of drug resistance.

Non-coding RNAs as potential targets in metformin therapy for cancer.

Metformin, a widely used oral hypoglycemic drug, has emerged as a potential therapeutic agent for cancer treatment. While initially known for its role in managing diabetes, accumulating evidence suggests that metformin exhibits anticancer properties through various mechanisms. Several cellular or animal experiments have attempted to elucidate the role of non-coding RNA molecules, including microRNAs and long non-coding RNAs, in mediating the anticancer effects of metformin. The present review summarized the current understanding of the mechanisms by which non-coding RNAs modulate the response to metformin in cancer cells. The regulatory roles of non-coding RNAs, particularly miRNAs, in key cellular processes such as cell proliferation, cell death, angiogenesis, metabolism and epigenetics, and how metformin affects these processes are discussed. This review also highlights the role of lncRNAs in cancer types such as lung adenocarcinoma, breast cancer, and renal cancer, and points out the need for further exploration of the mechanisms by which metformin regulates lncRNAs. In addition, the present review explores the potential advantages of metformin-based therapies over direct delivery of ncRNAs, and this review highlights the mechanisms of non-coding RNA regulation when metformin is combined with other therapies. Overall, the present review provides insights into the molecular mechanisms underlying the anticancer effects of metformin mediated by non-coding RNAs, offering novel opportunities for the development of personalized treatment strategies in cancer patients.

GLT-1 downregulation in hippocampal astrocytes induced by type 2 diabetes contributes to postoperative cognitive dysfunction in adult mice.

AIMS: Type 2 diabetes mellitus (T2DM) is related to an increased risk of postoperative cognitive dysfunction (POCD), which may be caused by neuronal hyperexcitability. Astrocyte glutamate transporter 1 (GLT-1) plays a crucial role in regulating neuron excitability. We investigated if T2DM would magnify the increased neuronal excitability induced by anesthesia/surgery (A/S) and lead to POCD in young adult mice, and if so, determined whether these effects were associated with GLT-1 expression. METHODS: T2DM model was induced by high fat diet (HFD) and injecting STZ. Then, we evaluated the spatial learning and memory of T2DM mice after A/S with the novel object recognition test (NORT) and object location test (OLT). Western blotting and immunofluorescence were used to analyze the expression levels of GLT-1 and neuronal excitability. Oxidative stress reaction and neuronal apoptosis were detected with SOD2 expression, MMP level, and Tunel staining. Hippocampal functional synaptic plasticity was assessed with long-term potentiation (LTP). In the intervention study, we overexpressed hippocampal astrocyte GLT-1 in GFAP-Cre mice. Besides, AAV-Camkllα-hM4Di-mCherry was injected to inhibit neuronal hyperexcitability in CA1 region. RESULTS: Our study found T2DM but not A/S reduced GLT-1 expression in hippocampal astrocytes. Interestingly, GLT-1 deficiency alone couldn't lead to cognitive decline, but the downregulation of GLT-1 in T2DM mice obviously enhanced increased hippocampal glutamatergic neuron excitability induced by A/S. The hyperexcitability caused neuronal apoptosis and cognitive impairment. Overexpression of GLT-1 rescued postoperative cognitive dysfunction, glutamatergic neuron hyperexcitability, oxidative stress reaction, and apoptosis in hippocampus. Moreover, chemogenetic inhibition of hippocampal glutamatergic neurons reduced oxidative stress and apoptosis and alleviated postoperative cognitive dysfunction. CONCLUSIONS: These findings suggest that the adult mice with type 2 diabetes are at an increased risk of developing POCD, perhaps due to the downregulation of GLT-1 in hippocampal astrocytes, which enhances increased glutamatergic neuron excitability induced by A/S and leads to oxidative stress reaction, and neuronal apoptosis.

Removal and recovery of nitrogen from anaerobically treated leachate based on a neglected HNAD nitrogen removal pathway: NH3 stripping.

The heterotrophic nitrification aerobic denitrification (HNAD) process can withstand the environment with high NH4+-N concentration and complex components, and has the potential to be an effective scheme for nitrogen removal of anaerobically treated leachate from municipal solid waste incineration plant. But its mechanism is still unclear and the NH3 stripping process has received little attention. At the same time, the high concentration of NH4+-N in the anaerobically treated leachate also has great recycling potential. In this study, typical HNAD microorganisms were enriched and used for nitrogen removal from anaerobically treated leachate. A one-step system with a total nitrogen removal ratio of more than 98 % was constructed. Isotopic labeling experiments showed that nitrogen was not the main product. The important role of NH3 stripping in the HNAD system was defined, and 46.63 % nitrogen was recovered on this basis.

Evaluation of the quality and readability of ChatGPT responses to frequently asked questions about myopia in traditional Chinese language.

Introduction: ChatGPT can serve as an adjunct informational tool for ophthalmologists and their patients. However, the reliability and readability of its responses to myopia-related queries in the Chinese language remain underexplored. Purpose: This study aimed to evaluate the ability of ChatGPT to address frequently asked questions (FAQs) about myopia by parents and caregivers. Method: Myopia-related FAQs were input three times into fresh ChatGPT sessions, and the responses were evaluated by 10 ophthalmologists using a Likert scale for appropriateness, usability, and clarity. The Chinese Readability Index Explorer (CRIE) was used to evaluate the readability of each response. Inter-rater reliability among the reviewers was examined using Cohen's kappa coefficient, and Spearman's rank correlation analysis and one-way analysis of variance were used to investigate the relationship between CRIE scores and each criterion. Results: Forty-five percent of the responses of ChatGPT in Chinese language were appropriate and usable and only 35% met all the set criteria. The CRIE scores for 20 ChatGPT responses ranged from 7.29 to 12.09, indicating that the readability level was equivalent to a middle-to-high school level. Responses about the treatment efficacy and side effects were deficient for all three criteria. Conclusions: The performance of ChatGPT in addressing pediatric myopia-related questions is currently suboptimal. As parents increasingly utilize digital resources to obtain health information, it has become crucial for eye care professionals to familiarize themselves with artificial intelligence-driven information on pediatric myopia.

Selection strategy for endoscopic necrosectomy approaches of infected walled-off pancreatic necrosis: Analysis of 101 patients from a single center with long-term follow-up.

OBJECTIVES: Endoscopic necrosectomy (EN) is a promising minimally invasive approach for treating infected walled-off pancreatic necrosis (WOPN). Multiple EN approaches are currently available, though criteria for selecting the optimal approaches are lacking. We aimed to propose a rational selection strategy of EN and to retrospectively evaluate its safety and effectiveness. METHODS: Altogether 101 patients who underwent EN for infected WOPN at a tertiary hospital between June 2009 and February 2023 were retrospectively included for analysis. Demographic characteristics, details of the EN procedures, procedure-related adverse events, and clinical outcomes were investigated. RESULTS: Among these 101 patients with WOPN, 56 (55.4%) underwent transluminal EN, 38 (37.6%) underwent percutaneous EN, and seven (6.9%) underwent combined approach, respectively. Clinical success was achieved in 94 (93.1%) patients. Seven (6.9%) experienced procedure-related adverse events, and seven (6.9%) died during the treatment period. During a median follow-up of 50 months, 5 (5.3%) of the 94 patients had disease recurrence, 17.0% (16/94) had new-onset diabetes mellitus, and 6.4% (6/94) needed oral pancreatic enzyme supplementation. The clinical success rate, procedure-related adverse event rate, and long-term follow-up outcomes were not significantly different among the three groups. High APACHE-II scores (≥15) and organ failure were identified as factors related to treatment failure. CONCLUSIONS: A selection strategy for EN approaches, based on the extent of necrosis and its distance from the gastrointestinal lumen (using a threshold of 15 mm), is safe and effective for treating infected WOPN in both short-term and long-term outcomes.

Effects of ECM protein-coated surfaces on the generation of retinal pigment epithelium cells differentiated from human pluripotent stem cells.

Retinal degeneration diseases, such as age-related macular degeneration (AMD) and retinitis pigmentosa (RP), initially manifest as dysfunction or death of the retinal pigment epithelium (RPE). Subretinal transplantation of human pluripotent stem cell (hPSC)-derived RPE cells has emerged as a potential therapy for retinal degeneration. However, RPE cells differentiated from hPSCs using current protocols are xeno-containing and are rarely applied in clinical trials. The development of hPSC-derived RPE cell differentiation protocols using xeno-free biomaterials is urgently needed for clinical applications. In this study, two protocols (the activin A and NIC84 protocols) were selected for modification and use in the differentiation of hiPSCs into RPE cells; the chetomin concentration was gradually increased to achieve high differentiation efficiency of RPE cells. The xeno-free extracellular matrix (ECM) proteins, laminin-511, laminin-521 and recombinant vitronectin, were selected as plate-coating substrates, and a Matrigel (xeno-containing ECM)-coated surface was used as a positive control. Healthy, mature hPSC-derived RPE cells were transplanted into 21-day-old Royal College of Surgeons (RCS) rats, a model of retinal degeneration disease. The visual function of RCS rats was evaluated by optomotor response (qOMR) and electroretinography after transplantation of hPSC-derived RPE cells. Our study demonstrated that hPSCs can be efficiently differentiated into RPE cells on LN521-coated dishes using the NIC84 protocol, and that subretinal transplantation of the cell suspensions can delay the progression of vision loss in RCS rats.

Assessing the Performance of Models from the 2022 RSNA Cervical Spine Fracture Detection Competition at a Level I Trauma Center.

"Just Accepted" papers have undergone full peer review and have been accepted for publication in Radiology: Artificial Intelligence. This article will undergo copyediting, layout, and proof review before it is published in its final version. Please note that during production of the final copyedited article, errors may be discovered which could affect the content. Purpose To evaluate the performance of the top models from the RSNA 2022 Cervical Spine Fracture Detection challenge on a clinical test dataset of both noncontrast and contrast-enhanced CT scans acquired at a level I trauma center. Materials and Methods Seven top-performing models in the RSNA 2022 Cervical Spine Fracture Detection challenge were retrospectively evaluated on a clinical test set of 1,828 CT scans (1,829 series: 130 positive for fracture, 1,699 negative for fracture; 1,308 noncontrast, 521 contrast-enhanced) from 1,779 patients (mean age, 55.8 ± 22.1 years; 1,154 male). Scans were acquired without exclusion criteria over one year (January to December 2022) from the emergency department of a neurosurgical and level I trauma center. Model performance was assessed using area under the receiver operating characteristic curve (AUC), sensitivity, and specificity. False positive and false negative cases were further analyzed by a neuroradiologist. Results Although all 7 models showed decreased performance on the clinical test set compared with the challenge dataset, the models maintained high performances. On noncontrast CT scans, the models achieved a mean AUC of 0.89 (range: 0.81-0.92), sensitivity of 67.0% (range: 30.9%-80.0%), and specificity of 92.9% (range: 82.1%-99.0%). On contrast-enhanced CT scans, the models had a mean AUC of 0.88 (range: 0.76-0.94), sensitivity of 81.9% (range: 42.7%-100.0%), and specificity of 72.1% (range: 16.4%-92.8%). The models identified 10 fractures missed by radiologists. False-positives were more common in contrast-enhanced scans and observed in patients with degenerative changes on noncontrast scans, while false-negatives were often associated with degenerative changes and osteopenia. Conclusion The winning models from the 2022 RSNA AI Challenge demonstrated a high performance for cervical spine fracture detection on a clinical test dataset, warranting further evaluation for their use as clinical support tools. ©RSNA, 2024.

Spatiotemporal evolution of land use efficiency in 357 cities across mainland China from 2000 to 2020 based on SDG 11.3.1.

High-efficiency land use facilitates the maximization of land utilization, lowers urban construction costs, and optimizes urban functional patterns. The Sustainable Development Goal 11.3.1 (SDG 11.3.1) can be used to assess land use efficiency (LUE), understand the current state of land use, and identify the potential for optimization. This study combines SDG 11.3.1 with other supplementary indicators to establish a land use efficiency evaluation system. This system provides a more precise understanding of internal city changes and enables a scientific assessment of urban LUE in Mainland China. The results showed that: (1) A significant number of cities were growing cities, particularly in the eastern region, with the population of built-up areas increased by 2.92 times from 2000 to 2020; (2) From 2000 to 2020, cities in China underwent rapid urban expansion, with the most significant urban expansion index in 2015-2020; (3) The coordination between population growth rate (PGR) and land consumption rate (LCR) worsened in the western region, while the central and eastern regions showed better coordination. (4) As the urban expansion index increased, the compactness index of the cities in the above three regions decreased and were at lower levels. This study establishes an evaluation system to assess the LUE and reveals the spatial and temporal characteristics of urban and population change. It holds paramount significance in enhancing LUE and encouraging sustainable development in Mainland China and serves as a valuable reference for global urban management.

AR-AI assisted ophthalmic nursing: Preliminary usability study in clinical settings.

Objective: Ophthalmic ward nursing work is onerous and busy, and many researchers have tried to introduce artificial intelligence (AI) technology to assist nurses in performing nursing tasks. This study aims to use augmented reality (AR) and AI technology to develop an intelligent assistant system for ophthalmic ward nurses and evaluate the usability and acceptability of the system in assisting clinical work for nurses. Methods: Based on AR technology, under the framework of deep learning, the system management, functions, and interfaces were completed using acoustic recognition, voice interaction, and image recognition technologies. Finally, an intelligent assistance system with functions such as patient face recognition, automatic information matching, and nursing work management was developed. Ophthalmic day ward nurses were invited to participate in filling out the System Usability Scale (SUS). Using the AR-based intelligent assistance system (AR-IAS) as the experimental group and the existing personal digital assistant (PDA) system as the control group. The experimental results of the three subscales of learnability, efficiency, and satisfaction of the usability scale were compared, and the clinical usability score of the AR-IAS system was calculated. Results: This study showed that the AR-IAS and the PDA systems had learnability subscale scores of 22.50/30.00 and 21.00/30.00, respectively; efficiency subscale scores of 29.67/40.00 and 28.67/40.00, respectively; and satisfaction subscale scores of 23.67/30.00 and 23.17/30.00, respectively. The overall usability score of the AR-IAS system was 75.83/100.00. Conclusion: Based on the analysis results of the System Usability Scale, the AR-IAS system developed using AR and AI technology has good overall usability and can be accepted by clinical nurses. It is suitable for use in ophthalmic nursing tasks and has clinical promotion and further research value.

The Novel Application of EUK-134 in Retinal Degeneration: Preventing Mitochondrial Oxidative Stress-Triggered Retinal Pigment Epithelial Cell Apoptosis by Suppressing MAPK/p53 Signaling Pathway.

Age-related macular degeneration (AMD), a leading cause of blindness, is characterized by mitochondrial dysfunction of retinal pigment epithelium (RPE) cells. EUK-134 is a mimetic of SOD2 and catalase, widely used for its antioxidant properties in models of light-induced damage or oxidative stress. However, its effects on the retina are not yet clear. Here, we investigated the capability of EUK-134 in averting AMD using sodium iodate (NaIO3)-induced Balb/c mouse and ARPE-19 cells (adult RPE cell line). In vivo, EUK-134 effectively antagonized NaIO3-induced retinal deformation and prevented outer and inner nuclear layer thinning. In addition, it was found that the EUK-134-treated group significantly down-regulated the expression of cleaved caspase-3 compared with the group treated with NaIO3 alone. Our results found that EUK-134 notably improved cell viability by preventing mitochondrial ROS accumulation-induced membrane potential depolarization-mediated apoptosis in NaIO3-inducted ARPE-19 cells. Furthermore, we found that EUK-134 could inhibit p-ERK, p-p38, p-JNK, p-p53, Bax, cleaved caspase-9, cleaved caspase-3, and cleaved PARP by increasing Bcl-2 protein expression. Additionally, we employed MAPK pathway inhibitors by SB203580 (a p38 inhibitor), U0126 (an ERK inhibitor), and SP600125 (a JNK inhibitor) to corroborate the aforementioned observation. The results support that EUK-134 may effectively prevent mitochondrial oxidative stress-mediated retinal apoptosis in NaIO3-induced retinopathy.

Elevated CO2 and Nitrogen Supply Boost N Use Efficiency and Wheat (T. aestivum cv. Yunmai) Growth and Differentiate Soil Microbial Communities Related to Ammonia Oxidization.

Elevated CO2 levels (eCO2) pose challenges to wheat (Triticum aestivum L.) growth, potentially leading to a decline in quality and productivity. This study addresses the effects of two ambient CO2 concentrations (aCO2, daytime/nighttime = 410/450 ± 30 ppm and eCO2, 550/600 ± 30 ppm) and two nitrogen (N) supplements (without N supply-N0 and with 100 mg N supply as urea per kg soil-N100) on wheat (T. aestivum cv. Yunmai) growth, N accumulation, and soil microbial communities related to ammonia oxidization. The data showed that the N supply effectively mitigated the negative impacts of eCO2 on wheat growth by reducing intercellular CO2 concentrations while enhancing photosynthesis parameters. Notably, the N supply significantly increased N concentrations in wheat tissues and biomass production, thereby boosting N accumulation in seeds, shoots, and roots. eCO2 increased the agronomic efficiency of applied N (AEN) and the physiological efficiency of applied N (PEN) under N supply. Plant tissue N concentrations and accumulations are positively related to plant biomass production and soil NO3--N. Additionally, the N supply increased the richness and evenness of the soil microbial community, particularly Nitrososphaeraceae, Nitrosospira, and Nitrosomonas, which responded differently to N availability under both aCO2 and eCO2. These results underscore the importance and complexity of optimizing N supply and eCO2 for enhancing crop tissue N accumulation and yield production as well as activating nitrification-related microbial activities for soil inorganic N availability under future global environment change scenarios.

Impacts of Elevated CO2 and a Nitrogen Supply on the Growth of Faba Beans (Vicia faba L.) and the Nitrogen-Related Soil Bacterial Community.

Ecosystems that experience elevated CO2 (eCO2) are crucial interfaces where intricate interactions between plants and microbes occur. This study addressed the impact of eCO2 and a N supply on faba bean (Vicia faba L.) growth and the soil microbial community in auto-controlled growth chambers. In doing so, two ambient CO2 concentrations (aCO2, daytime/nighttime = 410/460 ppm; eCO2, 550/610 ppm) and two N supplement levels (without a N supply-N0-and 100 mg N as urea per kg of soil-N100) were applied. The results indicated that eCO2 mitigated the inhibitory effects of a N deficiency on legume photosynthesis and affected the CO2 assimilation efficiency, in addition to causing reduced nodulation. While the N addition counteracted the reductions in the N concentrations across the faba beans' aboveground and belowground plant tissues under eCO2, the CO2 concentrations did not significantly alter the soil NH4+-N or NO3--N responses to a N supply. Notably, under both aCO2 and eCO2, a N supply significantly increased the relative abundance of Nitrososphaeraceae and Nitrosomonadaceae, while eCO2 specifically reduced the Rhizobiaceae abundance with no significant changes under aCO2. A redundancy analysis (RDA) highlighted that the soil pH (p < 0.01) had the most important influence on the soil microbial community. Co-occurrence networks indicated that the eCO2 conditions mitigated the impact of a N supply on the reduced structural complexity of the soil microbial communities. These findings suggest that a combination of eCO2 and a N supply to crops can provide potential benefits for managing future climate change impacts on crop production.

L-Band Synthetic Aperture Radar and Its Application for Forest Parameter Estimation, 1972 to 2024: A Review.

Optical remote sensing can effectively capture 2-dimensional (2D) forest information, such as woodland area and percentage forest cover. However, accurately estimating forest vertical-structure relevant parameters such as height using optical images remains challenging, which leads to low accuracy of estimating forest stocks like biomass and carbon stocks. Thus, accurately obtaining vertical structure information of forests has become a significant bottleneck in the application of optical remote sensing to forestry. Microwave remote sensing such as synthetic aperture radar (SAR) and polarimetric SAR provides the capability to penetrate forest canopies with the L-band signal, and is particularly adept at capturing the vertical structure information of forests, which is an alternative ideal remote-sensing data source to overcome the aforementioned limitation. This paper utilizes the Citexs data analysis platform, along with the CNKI and PubMed databases, to investigate the advancements of applying L-band SAR technology to forest canopy penetration and structure-parameter estimation, and provides a comprehensive review based on 58 relevant articles from 1978 to 2024 in the PubMed database. The metrics, including annual publication numbers, countries/regions from which the publications come, institutions, and first authors, with the visualization of results, were utilized to identify development trends. The paper summarizes the state of the art and effectiveness of L-band SAR in addressing the estimation of forest height, moisture, and forest stocks, and also examines the penetration depth of the L-band in forests and highlights key influencing factors. This review identifies existing limitations and suggests research directions in the future and the potential of using L-band SAR technology for forest parameter estimation.

AB078. Patterns of treatment delay in patients with symptomatic metastatic epidural spinal cord compression.

BACKGROUND: Delayed treatment in symptomatic metastatic epidural spinal cord compression (MESCC) is significantly associated with poorer functional outcomes. In this study, we aim to identify the patterns of treatment delay in patients and factors predictive of postoperative ambulatory function. METHODS: Retrospective review of patients with symptomatic MESCC treated surgically between January 2015 and January 2022. MESCC symptoms were categorized into symptoms suggesting cord compression requiring immediate referral and symptoms suggestive of spinal metastases. Multivariate analysis was performed to identify factors predictive of postoperative ambulatory function. Delays in treatment were identified and categorized into patient delay (onset of symptoms till initial medical consultation), diagnostic delay (medical consultation till radiological diagnosis of MESCC), referral delay (from diagnosis till spine surgeon review) and surgical delay (from spine surgeon review till surgery) and compared between patients. RESULTS: One hundred and seventy-eight patients were identified. In this cohort 92 (52.0%) patients were able to ambulate independently, and 86 (48.3%) patients were non independent. One hundred and thirty-nine (78.1%) of patients had symptoms of cord compression and 93 (52.3%) had neurological deficits on presentation. On multivariate analysis, pre-operative neurological deficits (P=0.01) and symptoms of cord compression (P=0.01) were significantly associated with post-operative ambulatory function. Mean total delay was 66 days, patient delay was 41 days, diagnostic delay was 16 days, referral delay was 3 days and surgical delay was 6 days. In patients with neurological deficits, there was a significant decrease in all forms of treatment delay (P<0.05). There was no significant decrease in patient delay, diagnostic delay and referral delay in patients with symptoms of cord compression. CONCLUSIONS: Both patients and physicians understand the need for urgent surgical treatment of MESCC with neurological deficits, however there is still a need for increased education and recognition of the symptoms of MESCC.

AB077. An evaluation of prognostic scoring systems for survival in a surgically treated cohort of 318 metastatic spine tumour surgery patients.

BACKGROUND: Survival prognostication plays a key role in the decision-making process for the surgical treatment of patients with spinal metastases. In the past traditional scoring systems such as the modified Tokuhashi and Tomita scoring systems have been used extensively, however in recent years their accuracy has been called into question. This has led to the development of machine learning algorithms to predict survival. In this study, we aim to compare the accuracy of prognostic scoring systems in a surgically treated cohort of patients. METHODS: This is a retrospective review of 318 surgically treated spinal metastases patients between 2009 and 2021. The primary outcome measured was survival from the time of diagnosis. Predicted survival at 3 months, 6 months and 1 year based on the prognostic scoring system was compared to actual survival. Predictive values of each scoring system were measured via area under receiver operating characteristic curves (AUROC). The following scoring systems were compared, Modified Tokuhashi (MT), Tomita (T), Modified Bauer (MB), Van Den Linden (VDL), Oswestry (O), New England Spinal Metastases score (NESMS), Global Spine Study Tumor Group (GSTSG) and Skeletal Oncology Research Group (SORG) scoring systems. RESULTS: For predicting 3 months survival, the GSTSG 0.980 (0.949-1.0) and NESM 0.980 (0.949-1.0) had outstanding predictive value, while the SORG 0.837 (0.751-0.923) and O 0.837 (0.775-0.900) had excellent predictive value. While for 6 months survival, only the O 0.819 (0.758-0.880) had excellent predictive value and the GSTSG 0.791(0.725-0.857) had acceptable predictive value. For 1 year survival, the NESM 0.871 (0.822-0.919) had excellent predictive value and the O 0.722 (0.657-0.786) had acceptable predictive value. The MT, T and MB scores had an area under the curve (AUC) of <0.5 for 3-month, 6-month and 1-year survival. CONCLUSIONS: Increasingly, traditional scoring systems such as the MT, T and MB scoring systems have become less predictive. While newer scoring systems such as the GSTSG, NESM and SORG have outstanding to excellent predictive value, there is no one survival scoring system that is able to accurately prognosticate survival at all 3 time points. A multidisciplinary, personalised approach to survival prognostication is needed.