The incidence of brain trauma caused by road injuries: Results from the Global Burden of Disease Study 2019.

BACKGROUND: Road collisions are a significant source of traumatic brain injury (TBI). We aimed to determine the pattern of road injury related TBI (RI-TBI) incidence, as well as its temporal trends. METHODS: We collected detailed information on RI-TBI between 1990 and 2019, derived from the Global Burden of Disease Study 2019. Estimated annual percentage changes (EAPCs) of RI-TBI age standardized incidence rate (ASIR), by sex, region, and cause of road injuries, were assessed to quantify the temporal trends of RI-TBI burden. RESULTS: Globally, incident cases of RI-TBI increased 68.1% from 6,900,000 in 1990 to 11,600,000 in 2019. The overall ASIR increased by an average of 0.43% (95% CI 0.30%-0.56%) per year during this period. The ASIR of RI-TBI due to cyclist, motorcyclist and other road injuries increased between 1990 and 2019; the corresponding EAPCs were 0.56 (95% CI 0.37-0.75), 1.60 (95% CI 1.35-1.86), and 0.75 (95% CI 0.59-0.91), respectively. In contrast, the ASIR of RI-TBI due to motor vehicle and pedestrian decreased with an EAPC of -0.12 and -0.14 respectively. The changing pattern for RI-TBI was heterogeneous across countries and regions. The most pronounced increases were observed in Mexico (EAPC = 3.74), followed by China (EAPC = 2.45) and Lesotho (EAPC = 1.91). CONCLUSIONS: RI-TBI remains a major public health concern worldwide, although road safety legislations have contributed to the decreasing incidence in some countries. We found an unfavorable trend in several countries with a relatively low socio-demographic index, suggesting that much more targeted and specific approaches should be adopted in these areas to forestall the increase in RI-TBI.

Tumor mutational burden and efficacy of chemotherapy in lung cancer.

PURPOSE: TMB is one of the potent biomarkers of response to immune checkpoint blockade. The association between TMB and efficacy of chemotherapy in advanced lung cancer has not been comprehensively explored. METHODS: Ninety lung cancer patients receiving first-line chemotherapy with large panel next-generation sequencing data of pre-treatment tumor tissue were identified. The effect of TMB on PFS of chemotherapy were evaluated in univariate and multivariate analyses. RESULTS: The median TMB level of lung cancer patients enrolled in this study was 9.4 mutations/Mb, with TMB levels in smokers significantly higher than those in non-smokers. All patients were divided into high TMB and low TMB groups with the cutoff of the median TMB. The patients with low TMB had longer PFS of first-line chemotherapy (median PFS 9.77 vs 6.33 months, HR = 0.523, 95% CI 0.32-0.852, log-rank P = 0.009). Subgroup analysis showed that PFS of chemotherapy favored low TMB than high TMB among subgroups of male, age < 60, NSCLC, adenocarcinoma, stage IV, ECOG PS 0, driver mutation positive, TP53 wild type and patients not receiving bevacizumab. In multivariate analysis, PFS of chemotherapy remained significantly longer in low TMB group (HR = 0.554, p = 0.036). In those patients received immunotherapy upon unsatisfactory chemotherapy, PFS of immunotherapy was much longer in high TMB group (median PFS 32.88 vs 6.62 months, HR = 0.2426, 95% CI 0.06-0.977, log-rank P = 0.04). CONCLUSIONS: TMB level of tumor tissue is a potent biomarker for efficacy of chemotherapy and immunotherapy in lung cancer. It may provide some clues for the decision of treatment strategy.

Cytokine-driven positive feedback loop organizes fibroblast transformation and facilitates gastric cancer progression.

BACKGROUND: Gastric cancer (GC) is a malignancy that belongs to one of the most common leading causes of cancer death. Cancer-associated fibroblasts (CAFs) promote the GC cells' malignant behavior. It is still unknown how GC converts normal fibroblasts (NFs) to CAFs. METHODS: GC cells were co-cultured with NFs. Bioinformatics was used to analyze the genes and signaling pathways that were changed in fibroblast. RT-PCR, western blot, and Elisa assays were used to detect the expression of cytokines in fibroblast and condition medium. Western blot and immunofluorescence demonstrated activation of relevant pathways in CAFs-like cells. Transwell, scrape, colony formation, and CCK-8 assays were performed to reveal the feedback effect of CAFs-like cells on GC cells. RESULTS: GC promoted the conversion of NFs to CAFs by secreting Interleukin 17A (IL-17). It included both morphological and molecular marker changes. This process was achieved by activating the nuclear factor-κB (NF-κB) pathway. On the other hand, CAFs cells could secrete C-X-C Motif Chemokine Ligand 8 (IL-8, IL-8), which promoted the malignant phenotype of GC cells. In this way, a feedback loop of mutual influence was constructed in the GC and tumor microenvironment (TME). CONCLUSIONS: Our research proved a novel model of GC-educated NFs. GC-IL-17-fibroblast-IL-8-GC axis might be a potential pathway of the interaction between GC and TME.

Wheat growth and nutrient uptake after phosphorus and potassium applications in saline-sodic field of semi-arid region / Crescimento do trigo e absorção de nutrientes após aplicações de fósforo e potássio em campo salino-sódico do semi-árido

Nutrient deficiency is a limiting factor in saline-sodic soils resulting in low crop production. The study investigated wheat response to P and K added to soils. The K was applied at 0 (K0), 75 (K1), 150 (K2) kg K2O ha-1 as K2S04 and at (0 (P0), 60 (P1), 120 (P2) kg P2O5 ha-1 as (NH4)2HPO4 in three replications under two-factorial randomized complete block (RCB) design. Both treatments significantly enhanced wheat grain (118%) and dry matter yield (60%) at P2K2 compared to control. The P treatments significantly affected leaf P, Mg, SO4, Ca:P, SO4:P ratios and soil P, Ca:P, Cl:P and SO4:P ratios, while K on leaf K, Na, Ca, SO4 concentration, K:Na, K:Ca, SO4:P,Ca:P ratios and soil pH, Na, K, Ca, SO4 concentrations, SAR, Na:K, Ca:K and Na:Ca ratios. Leaf Na was decreased to 85.3 mmol (+) kg-1 at K2 compared to 105.3 mmol (+) kg-1at P2K0. Negative correlation (R2=0.906) of leaf K:Na was found with leaf Na concentration. The correlation of dry matter was higher (R2=0.851) with leaf K:Na ratio than grain yield (R2=0.392). It is concluded that the addition of K and P addition shows beneficial effects in improving crop nutrition and wheat yield in the saline-sodic soil environment.

A deficiência de nutrientes é um fator limitante em solos salino-sódicos, resultando em baixa produção agrícola. O estudo investigou a resposta do trigo ao P e K adicionados ao solo. O K foi aplicado em 0 (K0), 75 (K1), 150 (K2) kg K2O ha-1 como K2S04 e em (0 (P0), 60 (P1), 120 (P2) kg P2O5 ha-1 como (NH4)2HPO4 em três repetições sob delineamento de blocos completos casualizados (RCB) de dois fatores. Ambos os tratamentos aumentaram significativamente o rendimento de grãos de trigo (118%) e de matéria seca (60%) em P2K2 em comparação com o controle. Os tratamentos com P afetaram significativamente o P foliar, Mg, SO4, as razões Ca:P, SO4:P e o P do solo, e as razões Ca:P, Cl:P e SO4:P, enquanto K no K foliar, Na, Ca, concentração de SO4, razões K:Na, K:Ca, SO4:P, Ca:P e pH do solo, Na, K, Ca, concentrações de SO4, SAR, razões Na:K, Ca:K e Na:Ca. O Na da folha foi reduzido para 85,3 mmol (+) kg-1 em K2 em comparação com 105,3 mmol (+) kg-1 em P2K0. Correlação negativa (R2 = 0,906) do K:Na na folha foi encontrada com a concentração de Na na folha. A correlação da matéria seca foi maior (R2 = 0,851) com a relação K:Na da folha do que rendimento de grãos (R2 = 0,392). Conclui-se que a adição de K e P apresenta efeitos benéficos na melhoria da nutrição da cultura e na produtividade do trigo em solo salino-sódico

Approaches to involuntary admission of the mentally ill in the People's Republic of China: changes in legislation from 2002 to 2012.

A systematic analysis of laws on involuntary commitment of mentally ill individuals in China has never been undertaken. In this article, we explore the trajectory of the legislation and discuss the social and cultural factors underlying the changes in the laws. In this description and analysis of the differences and similarities in the current legal framework and procedures for involuntary commitment of the mentally ill across the mental health regulations of seven localities and the National Mental Health Law, one can see a gradual trend toward more stringent legislation during the past 10 years. The compromises, reversals, and circuitous course of the legislative process reflect the difficulties that the government faced in achieving a balance between benefits to society and the individual as it attempted to revamp the delivery of mental health services. The 2012 National Mental Health Law, despite some weaknesses, is an important step toward standardizing the diverse practices in involuntary admission of mentally ill persons in China. Further research on the influence of the National Law on mental health services is clearly needed.