Engineering biomimetic nanosystem targeting multiple tumor radioresistance hallmarks for enhanced radiotherapy.

Tumor cells establish a robust self-defense system characterized by hypoxia, antioxidant overexpression, DNA damage repair, and so forth to resist radiotherapy. Targeting one of these features is insufficient to overcome radioresistance due to the feedback mechanisms initiated by tumor cells under radiotherapy. Therefore, we herein developed an engineering biomimetic nanosystem (M@HHPt) masked with tumor cell membranes and loaded with a hybridized protein-based nanoparticle carrying oxygens (O2) and cisplatin prodrugs (Pt(IV)) to target multiple tumor radioresistance hallmarks for enhanced radiotherapy. After administration, M@HHPt actively targeted and smoothly accumulated in tumor cells by virtue of its innate homing abilities to realize efficient co-delivery of O2 and Pt(IV). O2 introduction induced hypoxia alleviation cooperated with Pt(IV) reduction caused glutathione consumption greatly amplified radiotherapy-ignited cellular oxidative stress. Moreover, the released cisplatin effectively hindered DNA damage repair by crosslinking with radiotherapy-produced DNA fragments. Consequently, M@HHPt-sensitized radiotherapy significantly suppressed the proliferation of lung cancer H1975 cells with an extremely high sensitizer enhancement ratio of 1.91 and the progression of H1975 tumor models with an excellent tumor inhibition rate of 94.7%. Overall, this work provided a feasible strategy for tumor radiosensitization by overcoming multiple radioresistance mechanisms.

Evaluation of the DGT passive samplers for integrating fluctuating concentrations of pharmaceuticals in surface water.

Diffusive gradients in thin films (DGTs) have been well-documented for the measurement of a broad range of organic pollutants in surface water. However, the performance has been challenged by the inherent periodic concentration fluctuations for most organic pollutants. Therefore, there is an urgent need to assess the true time-weighted average (TWA) concentration based on fluctuating concentration profiles. The study aimed to evaluate the responsiveness of DGT and accuracy of TWA concentrations, considering various concentration fluctuating scenarios of 20 pharmaceuticals in surface water. The reliability and accuracy of the TWA concentrations measured by the DGT were assessed by comparison with the sum of cumulative mass of DGT exposed at different stages over the deployment period. The results showed that peak concentration duration (1-5 days), peak concentration fluctuation intensity (6-20 times), and occurrence time of peak concentration fluctuation (early, middle, and late stages) have minimal effect on DGT's response to most target pharmaceutical concentration fluctuations (0.8 < CDGT/CTWA < 1.2). While the downward-bent accumulations of a few pharmaceuticals on DGT occur as the sampling time increases, which could be accounted for by capacity effects during a long-time sampling period. Additionally, the DGT device had good sampling performance in recording short fluctuating concentrations from a pulse event returning to background concentrations with variable intensity and duration. This study revealed a satisfactory capacity for the evaluation of the TWA concentration of pharmaceuticals integrated over the period of different pulse deployment for DGT, suggesting that this passive sampler is ideally suited as a monitoring tool for field application. This study represents the first trial for evaluating DGT sampling performance for pharmaceuticals with multiple concentration fluctuating scenarios over time, which would be valuable for assessing the pollution status in future monitoring campaign.

Regulating luminescence thermal enhancement in negative thermal expansion metal-organic frameworks.

Overcoming thermal quenching is generally essential for the practical application of luminescent materials. It has been recently found that frameworks with negative thermal expansion (NTE) could be a promising candidate to engineer unconventional luminescence thermal enhancement. However, the mechanism through which luminescence thermal enhancement can be well tuned remains an open issue. In this work, enabled by altering ligands in a series of UiO-66 derived Eu-based metal-organic frameworks, it was revealed that the changes in the thermal expansion are closely related to luminescence thermal enhancement. The NTE of the aromatic ring part favors luminescence thermal enhancement, while contraction of the carboxylic acid part plays the opposite role. Modulation of functional groups in ligands can change the thermal vibration of aromatic rings and then achieve luminescence thermal enhancement in a wide temperature window. Our findings pave the way to manipulate the NTE and luminescence thermal enhancement based on ligand engineering.

Association between red cell distribution width-to-albumin ratio and prognostic outcomes in pediatric intensive care unit patients: a retrospective cohort study.

Objective: This study aimed to assess the association between Red Cell Distribution Width-to-Albumin Ratio (RAR) and the clinical outcomes in Pediatric Intensive Care Unit (PICU) patients. Design: This is a retrospective cohort study. Methods: We conducted a retrospective cohort study based on the Pediatric Intensive Care database. The primary outcome was the 28-day mortality rate. Secondary outcomes included the 90-day mortality rate, in-hospital mortality rate, and length of hospital stay. We explored the relationship between RAR and the prognosis of patients in the PICU using multivariate regression and subgroup analysis. Results: A total of 7,075 participants were included in this study. The mean age of the participants was 3.4 ± 3.8 years. Kaplan-Meier survival curves demonstrated that patients with a higher RAR had a higher mortality rate. After adjusting for potential confounding factors, we found that for each unit increase in RAR, the 28-day mortality rate increased by 6% (HR = 1.06, 95% CI: 1.01-1.11, P = 0.015). The high-RAR group (RAR ≥ 4.0) had a significantly increased 28-day mortality rate compared to the low-RAR group (RAR ≤ 3.36) (HR = 1.7, 95% CI: 1.23-2.37, P < 0.001). Similar results were observed for the 90-day and in-hospital mortality rate. No significant interactions were observed in the subgroup analysis. Conclusion: Our study suggests a significant association between RAR and adverse outcomes in PICU patients. A higher RAR is associated with higher 28-day, 90-day, and in-hospital mortality rates.

Colorimetric and surface-enhanced Raman scattering dual-mode lateral flow immunosensor using phage-displayed shark nanobody for the detection of crustacean allergen tropomyosin.

Tropomyosin (TM) is the primary allergenic protein responsible for crustacean food allergies, and thus sensitive and rapid methods are required for the screening of crustacean TM in food. In this study, using the phage-displayed shark nanobody (PSN) as a multifunctional biomaterial, we developed a colorimetric and surface-enhanced Raman scattering dual-mode lateral flow immunosensor (CM/SERS-LFI) for competitive detection of crustacean TM. The SERS tag AuMBA@AgNPs with the Raman signal molecule 4-mercaptobenzoic acid (4-MBA) was prepared and immobilized on the PSN to construct the immunoprobe AuMBA@Ag-PSN. The probe can identify free TM that competes with TM on the T-line, and the optimized CM/SERS-LFI enables quantitative analysis of TM using the probe with a limit of detection (LOD) of 0.0026 µg/mL (SERS mode) and 0.0057 µg/mL (colorimetric mode), respectively. Additionally, it can implement a qualitative analysis by the naked eye with a visual LOD of 0.01 µg/mL. The CM/SERS-LFI exhibited excellent performance in the tests of selectivity, accuracy, precision, and stability. Moreover, the method's effectiveness in the analysis of real samples was confirmed by a commercial ELISA kit. Therefore, the developed CM/SERS-LFI was demonstrated to be a powerful and reliable tool for the rapid and sensitive detection of crustacean TM in food.

Colorimetric and chemiluminescent enzyme immunoassays based on the alkaline phosphatase-tagged single-chain variable fragment fusion tracer for detecting zearalenone in agro-products.

Zearalenone (ZEN) is a non-steroidal estrogenic mycotoxin and seriously threatens food safety, which requires rapid and sensitive detection methods for monitoring ZEN in agro-products. Herein, an alkaline phosphatase-tagged single-chain variable fragment fusion protein (ALP-scFv) was used as a bifunctional tracer to develop a colorimetric enzyme immunoassay (CEIA) and a chemiluminescent enzyme immunoassay (CLEIA) for ZEN. In addition, the interactions between scFv and ZEN were exploited by computer-assisted simulation, and four key amino acid sites were preliminarily identified. After optimization, the CEIA and CLEIA exhibited a limit of detection of 0.02 and 0.006 ng/mL, respectively. Furthermore, both methods showed favorable accuracy in recovery experiments and good selectivity in cross reactions. Moreover, the detection results of the actual samples from both methods correlated well with those from high-performance liquid chromatography. Overall, the ALP-scFv fusion tracer-based CEIA and CLEIA are demonstrated as reliable tools for ZEN detection in food.

Hyperbranched Polymer Induced Antibacterial Tree-Like Nanofibrous Membrane for High Effective Air Filtration.

The air filtration materials with high efficiency, low resistance, and extra antibacterial property are crucial for personal health protection. Herein, a tree-like polyvinylidene fluoride (PVDF) nanofibrous membrane with hierarchical structure (trunk fiber of 447 nm, branched fiber of 24.7 nm) and high filtration capacity is demonstrated. Specifically, 2-hydroxypropyl trimethyl ammonium chloride terminated hyperbranched polymer (HBP-HTC) with near-spherical three-dimensional molecular structure and adjustable terminal positive groups is synthesized as an additive for PVDF electrospinning to enhance the jet splitting and promote the formation of branched ultrafine nanofibers, achieving a coverage rate of branched nanofibers over 90% that is superior than small molecular quaternary ammonium salts. The branched nanofibers network enhances mechanical properties and filtration efficiency (99.995% for 0.26 µm sodium chloride particles) of the PVDF/HBP-HTC membrane, which demonstrates reduced pressure drop (122.4 Pa) and a quality factor up to 0.083 Pa-1 on a 40 µm-thick sample. More importantly, the numerous quaternary ammonium salt groups of HBP-HTC deliver excellent antibacterial properties to the PVDF membranes. Bacterial inhibitive rate of 99.9% against both S. aureus and E. coli is demonstrated in a membrane with 3.0 wt% HBP-HTC. This work provides a new strategy for development of high-efficiency and antibacterial protection products.

Nonmetal catalyst boosting amplification of both colorimetric and electrochemical signal for multi-mode nitrite sensing.

Recently, nanozymes as an outstanding alternative to natural enzymes has attracted wide attention because of its high stability performance. In this study, PNC nonmetal nanozymes with high oxidase-like activity was synthesized can specifically catalyze colorless 3,3,5,5-tetramethyl-benzidine(TMB) to form blue oxidized TMB (TMBox). In the presence of nitrite, it further oxidizes TMBox to obtain yellow derivative products attributed to nitrite inducing diazotization reaction in TMBox. Based on this principle, a colorimetric and electrochemical sensing system was developed, and the ultra-sensitive multi-mode detection of nitrite was realized by combining RGB mode of smart phone, UV-Vis spectrum and electrochemical method. Compared with single signal detection, the multi-mode sensing system can realize self-validation to achieve more reliable detection results. What's more, the developed multi-mode sensing could quickly and sensitively detect nitrite in real sample, especially RGB mode of smart phone meeting the equipment limited areas, suggesting a broad application prospects in food safety.

Mitochondrial Localized In Situ Self-Assembly Reprogramming Tumor Immune and Metabolic Microenvironment for Enhanced Cancer Therapy.

The inherent immune and metabolic tumor microenvironment (TME) of most solid tumors adversely affect the antitumor efficacy of various treatments, which is an urgent issue to be solved in clinical cancer therapy. In this study, a mitochondrial localized in situ self-assembly system is constructed to remodel the TME by improving immunogenicity and disrupting the metabolic plasticity of cancer cells. The peptide-based drug delivery system can be pre-assembled into nanomicelles in vitro and form functional nanofibers on mitochondria through a cascade-responsive process involving reductive release, targeted enrichment, and in situ self-assembly. The organelle-specific in situ self-assemblyeffectively switches the role of mitophagy from pro-survival to pro-death, which finally induces intense endoplasmic reticulum stress and atypical type II immunogenic cell death. Disintegration of the mitochondrial ultrastructure also impedes the metabolic plasticity of tumor cells, which greatly promotes the immunosuppresive TME remodeling into an immunostimulatory TME. Ultimately, the mitochondrial localized in situ self-assembly system effectively suppresses tumor metastases, and converts cold tumors into hot tumors with enhanced sensitivity to radiotherapy and immune checkpoint blockade therapy. This study offers a universal strategy for spatiotemporally controlling supramolecular self-assembly on sub-organelles to determine cancer cell fate and enhance cancer therapy.

Lateral Flow Immunochromatographic Assay for Competitive Detection of Crustacean Allergen Tropomyosin Using Phage-Displayed Shark Single-Domain Antibody.

The common food allergy crustacean tropomyosin (TM) poses a significant food safety challenge, which requires rapid and sensitive methods for screening TM in food. Herein, the variable new antigen receptor (VNAR) single-domain antibodies specific for the crustacean TM were isolated from a naïve phage-displayed shark VNAR library. Subsequently, a lateral flow immunochromatographic assay (LFIA) based on the gold nanoparticle-labeled phage-displayed shark VNAR (AuNPs@PSV) probe was developed for the detection of TM in food. The AuNPs@PSV-LFIA took 15 min for one test and had a visual limit of detection (vLOD) of 0.1 µg/mL and an instrumental LOD of 0.02 µg/mL. Good selectivity, accuracy, precision, and stability were confirmed for the AuNPs@PSV-LFIA. Moreover, the test results of 21 commercially available food products consisted of the allergen labels and were validated by a commercial ELISA kit. Therefore, this work demonstrated the great potential of VNAR for detecting TM in food by LFIA.

Perspectives for the Role of Single-Atom Nanozymes in Assisting Food Safety Inspection and Food Nutrition Evaluation.

Single-atom nanozymes (SAzymes) have been greatly developed for rapid detection, owing to their rich active sites and excellent catalytic activity. Although several excellent reviews concentrating on SAzymes have been reported, they mainly focused on advanced synthesis, sensing mechanisms, and biomedical applications. To date, few reviews elaborate on the promising applications of SAzymes in food safety inspection and food nutrition evaluation. In this paper, we systematically reviewed the enzyme-like activity of SAzymes and the catalytic mechanism, in addition to recent research advances of SAzymes in the domain of food safety inspection and food nutrition evaluation in the past few years. Furthermore, current challenges hampering practical applications of SAzymes in food assay are summarized and analyzed, and possible research areas focusing on SAzyme-based sensors in rapid food testing are also proposed.

Economic burden attributable to healthcare-associated infections at western China hospitals: 6 Year, prospective cohort study.

OBJECTIVES: Healthcare-associated infections (HAIs) represent a major threat to patient safety and are associated with significant economic burden. Calculating the costs attributable to HAIs is challenging given the various sources of bias. Although HAIs as a reasonably preventable medical harm should have been closely linked to medical insurance incentives, there was little linkage between HAIs and medicare in western China owing to the lack of economic evaluation data. The present study aimed to generate estimates of the attributable costs associated with HAIs and the magnitude of costs growth. METHODS: In this cohort study designed horizontally and vertically from 2016 to 2022, we compared outcomes of randomly sampling patients with HAIs and individually matched patients without HAIs in two cohorts at a 6-year interval at 34 hospitals in western China. The primary outcome was the direct medical cost for the entire hospital stay, converted to US dollars ($ for the benchmark year), discounted at 3% annually, and estimated separately in the full analysis set (FAS) and the per protocol set (PPS). We used multiple linear regression to adjust the discounted costs and to assess subgroups effects within each cohort. We nested a dynamic vertical comparison of costs attributable to HAIs between the front and rear cohorts. RESULTS: A total of 230 patients with HAIs in 2016 and 204 patients with HAIs in 2022 were enrolled. After a 1:1 match, all 431 pairs were recruited as FAS, of which 332 pairs as PPS met all matching restrictions. Compared to the 2016 cohort in FAS, the patients with HAIs in 2022 had a significantly older age (64.40 ± 16.45 years), higher repeat hospitalization rate (65 [32.02%] of 203), and lower immune function (69 [33.99%] of 203). The discounted costs and adjusted-discounted costs for patients with HAIs in the 2022 cohort were found to be significantly higher than those of patients without HAIs (discounted costs: $5484.60 [IQR 8426.03] vs $2554.04(4530.82), P < 0.001; adjusted-discounted costs: $5235.90 [3772.12] vs $3040.21(1823.36), P < 0.001, respectively), and also higher than those of patients with HAIs in the 2016 cohort (discounted costs: $5484.60 [8426.03] vs $3553.00 [6127.79], P < 0.001; adjusted-discounted costs: $5235.90 [3772.12] vs $3703.82 [3159.14], P < 0.001, respectively). In vertical comparison of PPS, the incremental costs of the 2022 cohort are 1.48 times higher than those of the 2016 cohort ($964.63(4076.15) vs $652.43 [2533.44], P = 0.084). CONCLUSIONS: This meticulously designed study in western China has successfully and accurately examined the economic burden attributable to HAIs. Their rapidly increasing tendency poses a serious challenge to patients, hospitals, and the medical insurance. A closer linkage between HAIs and ongoing motivating system changes is urgently needed in western China.

Illuminating the path: aggregation-induced emission for food contaminants detection.

Food safety is a global concern that deeply affects human health. To ensure the profitability of the food industry and consumer safety, there is an urgent need to develop rapid, sensitive, accurate, and cost-effective detection methods for food contaminants. Recently, the Aggregation-Induced Emission (AIE) has been successfully used to detect food contaminants. AIEgens, fluorescent dyes that cause AIE, have several valuable properties including high quantum yields, photostability, and large Stokes shifts. This review provides a detailed introduction to the principles and advantages of AIE-triggered detection, followed by a focus on the past five years' applications of AIE in detecting various food contaminants including pesticides, veterinary drugs, mycotoxins, food additives, ions, pathogens, and biogenic amines. Each detection principle and component is comprehensively covered and explained. Moreover, the similarities and differences among different types of food contaminants are summarized, aiming to inspire future researchers. Finally, this review concludes with a discussion of the prospects for incorporating AIEgens more effectively into the detection of food contaminants.

Medication Status and Related Factors in Essential Tremor Patients: A Cross-Sectional Study in China.

INTRODUCTION: Essential tremor (ET) is one of the most common movement disorders. Oral drugs play a crucial role in treating ET, with various available options such as propranolol, primidone, and topiramate. However, the medication status and related factors among Chinese ET patients are unknown yet. METHODS: This study used the baseline data from the National Survey of Essential Tremor Plus in China cohort. ET patients with information related to medication intake were included. Medication patients were defined as patients who were taking medication at the time of the survey. We further defined recommended medication users according to Chinese guideline recommendations and clinical knowledge. We used mean and standard deviation (SD), median and interquartile range (IQR), or frequencies and percentages when appropriate for descriptive analysis. We used multivariate logistic regression analyses to explore factors related to medication intake in all ET patients and in recommended medication users. RESULTS: Of 1,153 included ET participants, 207 (18.0%) took medication. Arotinolol (115, 55.6%) and propranolol (63, 30.4%) were the top 2 used medicines. Patients with middle school education (odds ratio 0.57, 95% confidence interval 0.39-0.83), college or higher level education (0.46, 0.28-0.76), and late-onset ET (LO-ET) (0.38, 0.23-0.63) were less likely to take medication. Patients with intention tremor (1.90, 1.38-2.62), every 10-unit increase in age (1.10, 1.00-1.21), Tremor Research Group Essential Tremor Rating Assessment Scale (TETRAS) Part 1 (1.63, 1.37-1.93), and TETRAS Part 2 (1.81, 1.48-2.22) were more likely to take medication. Among 332 recommended medication users, only 104 (31.3%) took medicine. The associations of LO-ET (0.36, 0.17-0.75), intention tremor (2.27, 1.35-3.81), TETRAS Part 1 (1.52, 1.09-2.13), and TETRAS Part 2 (1.59, 1.15-2.20) with medication were similar to all ET patients. CONCLUSION: The proportion of medication intake is low among both all ET patients and recommended medication users. The top 2 commonly used medications among all ET patients are arotinolol and propranolol. Influencing factors of medication intake are different between all ET patients and recommended medication users. Clinicians are suggested to provide counseling and education on ET medication to promote medication intake.

Effect of cadmium stress on the bacterial community in the rhizosphere of mulberry (Morus alba L.).

Mulberry has a good tolerance to cadmium (Cd) and is considered a candidate plant for phytoremediation. The rhizosphere microbial community plays an important role in phytoremediation. Nevertheless, little information on the rhizosphere microbial community mechanisms in mulberry during the phytoremediation of Cd-contaminated soil is available. In this study, the remediation efficiency of mulberry in pots subjected to three simulated Cd pollution levels and their rhizosphere bacterial communities during the remediation process were analyzed. "Yuesang 11" was used as the test mulberry variety, and three simulated Cd pollution levels were set by adding three concentrations of Cd (Cd5, 5 mg kg-1; Cd3, 3 mg kg-1; Cd2, 2 mg kg-1). The results showed that the elimination rates of Cd in the rhizosphere soil were 81.7%, 85.3%, and 57.9% under the stress of the Cd2, Cd3, and Cd5 conditions, respectively. Meanwhile, 3,082,583 high-quality sequence reads and 976 operational taxonomic units were successfully obtained from the mulberry rhizosphere soil by high-throughput absolute quantification sequencing and further assigned to 11 bacterial phyla and 26 families. Of these, decreased abundances of 19 bacteria at the family level and increased abundances of seven bacteria under Cd stress were revealed by comparative analysis. Based on the alpha diversity indices (Chaol, Shannon and Simpson) and principal component analysis, the rhizosphere bacterial diversity of the Cd5 condition was significantly decreased, but that of the Cd2 and Cd3 conditions was not different from that of soil without Cd (CK). Likewise, redundancy analysis showed that the abundances of Acidobacteria Gp2, Acidobacteria Gp13, and Sphingobacteria were significantly positively associated with the elimination rates of Cd. This study suggested that the mulberry rhizosphere contains a relatively stable bacterial community consisting of diverse Cd-resistant bacteria, providing a scientific basis for remediating heavy-metal polluted soils using mulberry.

Wearable multisource quantitative gait analysis of Parkinson's diseases.

As the motor symptoms of Parkinson's disease (PD) are complex and influenced by many factors, it is challenging to quantify gait abnormalities adequately using a single type of signal. Therefore, a wearable multisource gait monitoring system is developed to perform a quantitative analysis of gait abnormalities for improving the effectiveness of the clinical diagnosis. To detect multisource gait data for an accurate evaluation of gait abnormalities, force sensitive sensors, piezoelectric sensors, and inertial measurement units are integrated into the devised device. The modulation circuits and wireless framework are designed to simultaneously collect plantar pressure, dynamic deformation, and postural angle of the foot and then wirelessly transmit these collected data. With the designed system, multisource gait data from PD patients and healthy controls are collected. Multisource features for quantifying gait abnormalities are extracted and evaluated by a significance test of difference and correlation analysis. The results show that the features extracted from every single type of data are able to quantify the health status of the subjects (p < 0.001, ρ > 0.50). More importantly, the validity of multisource gait data is verified. The results demonstrate that the gait feature fusing multisource data achieves a maximum correlation coefficient of 0.831, a maximum Area Under Curve of 0.9206, and a maximum feature-based classification accuracy of 88.3%. The system proposed in this study can be applied to the gait analysis and objective evaluation of PD.

The microbial oxidation of pharmaceuticals in an anaerobic aqueous environment: Effect of dissolved organic matter fractions from different sources.

Previous studies have demonstrated the importance of dissolved organic matter (DOM) on the biodegradation of trace organic contaminants occurred in the hyporheic zone. However, the role of diverse DOM fractions with distinct physicochemical properties on the biodegradation of pharmaceuticals under reducing conditions is scarcely known. To address this knowledge gap, DOMs derived from road-deposited sediment, soil, and active sludge (namely allochthonous DOM) and algae (namely autochthonous DOM) were collected and isolated into different fractions. Thereafter, the effect of DOM fractions on the anaerobic microbial oxidation of two typical pharmaceuticals, i.e., ritonavir (RTV) and tetracycline (TC) was explored by using simulated anaerobic microcosms. Mechanistic insights into how DOM fractions from different sources influence pharmaceutical biodegradation processes were provided by optical and electrochemical analyses. Results showed that humic acid and fulvic acid fractions from allochthonous DOM could enhance the biodegradation of TC (12.2 % per mgC/L) and RTV (14.5 % per mgC/L), while no significant impact was observed for that of hydrophilic fractions. However, autochthonous DOM promoted the biodegradation of TC (4.17 % per mgC/L) and inhibited that of RTV. Mechanistic analysis showed that the higher of humification and aromatization level of DOM components, the stronger their promotive effect on the biodegradation of TC and RTV. Further, the promotive mechanism could be attributed to the response of quinone moieties in DOM as extracellular electron acceptors that yields more energy to support microbial metabolism. These results provide a more comprehensive understanding of diverse DOM fractions mediating microbial anaerobic oxidation of trace organic pollutants, and extend our insights into contamination control and remediation technologies.

Cancer Stem-Like Cells-Oriented Surface Self-Assembly to Conquer Radioresistance.

Cancer stem-like cells (CSCs), capable of indefinite self-renewal and differentiation, are considered to be the root cause of tumor radiotherapy (RT) resistance. However, the CSCs-targeted therapy still remains to be a great challenge because they are commonly located in the deep tumor making drugs hard to approach, and their hypoxic and acidic niche can further aggravate radioresistance. Herein, based on the finding that hypoxic CSCs highly express carbonic anhydrase IX (CAIX) on the cell membrane, a CAIX-targeted induced in situ self-assembly system on the surface of CSC is reported to overcome hypoxic CSC-mediated radioresistance. Via the sequential processes of "monomer release-target accumulation-surface self-assembly", the constructed peptide-based drug delivery system (CA-Pt) exhibits the advantages of deep penetration, amplified CAIX inhibition, and enhanced cellular uptake, which greatly relieves the hypoxic and acidic microenvironment to promote the hypoxic CSC differentiation and combines with platinum to boost the RT-inducing DNA damage. In both lung cancer tumor mouse and zebrafish embryo models, CA-Pt treatment can effectively assist RT in suppressing tumor growth and preventing tumor invasion and metastasis. This study uses a surface-induced self-assembly strategy to differentiate hypoxic CSCs, which may provide a universal treatment strategy for overcoming tumor radioresistance.

EISA in Tandem with ICD to Form In Situ Nanofiber Vaccine for Enhanced Tumor Radioimmunotherapy.

Radiotherapy (RT) can produce a vaccine effect and remodel a tumor microenvironment (TME) by inducing immunogenic cell death (ICD) and inflammation in tumors. However, RT alone is insufficient to elicit a systemic antitumor immune response owing to limited antigen presentation, immunosuppressive microenvironment, and chronic inflammation within the tumor. Here, a novel strategy is reported for the generation of in situ peptide-based nanovaccines via enzyme-induced self-assembly (EISA) in tandem with ICD. As ICD progresses, the peptide Fbp-GD FD FD pY (Fbp-pY), dephosphorylated by alkaline phosphatase (ALP) forms a fibrous nanostructure around the tumor cells, resulting in the capture and encapsulation of the autologous antigens produced by radiation. Utilizing the adjuvant and controlled-release advantages of self-assembling peptides, this nanofiber vaccine effectively increases antigen accumulation in the lymph nodes and cross-presentation by antigen-presenting cells (APCs). In addition, the inhibition of cyclooxygenase 2 (COX-2) expression by the nanofibers promotes the repolarization of M2-macrophages into M1 and reduces the number of regulatory T cells (Tregs) and myeloid-derived suppressor cells (MDSCs) required for TME remodeling. As a result, the combination of nanovaccines and RT significantly enhances the therapeutic effect on 4T1 tumors compared with RT alone, suggesting a promising treatment strategy for tumor radioimmunotherapy.

Age and Sex Affect Essential Tremor (ET) Plus: Clinical Heterogeneity in ET Based on the National Survey in China.

The new term essential tremor (ET) plus was proposed in the 2018 tremor consensus criteria. The National Survey of Essential Tremor Plus in China, a large multicenter registry study, aimed to evaluate the clinical features of pure ET and ET plus and explore possible factors related to ET plus. All patients with ET underwent neurological examination and neuropsychological assessment at 17 clinical sites. The diagnosis was made according to the 2018 consensus criteria. Clinicodemographic characteristics were analyzed. A total of 1160 patients were included, including 546 patients with pure ET and 614 patients with ET plus. The proportion of females was significantly higher in the ET plus than that in the pure ET (P = 0.001). The age at onset (AAO) of pure ET showed a bimodal distribution, with peaks in the 2nd and 5th decades. However, the AAO of the ET plus group demonstrated a skewed distribution, with a single peak in the 6th decade. Female sex (OR=1.645, P<0.001), older age (OR=1.023, P<0.001), lower educational level (OR=0.934, P<0.001), head tremor (OR=1.457, P<0.001), and higher the Tremor Research Group Essential Tremor Rating Assessment Scale (TETRAS)-II scores (OR=1.134, P<0.001) were significantly associated with ET plus. Old age and female sex may contribute to ET plus development. Pure ET showed a bimodal distribution for AAO, whereas ET plus showed a unimodal distribution. It remains unclear whether pure ET and ET plus are merely different stages of a single disease or represent distinct disease entities.