Simultaneous quantification of mirabegron and vibegron in human plasma by HPLC-MS/MS and its application in the clinical determination in patients with tumors associated with overactive bladder.

Mirabegron and vibegron, both newly identified beta-3 adrenergic agonists, have significantly improved the quality of life for patients suffering from overactive bladder. In order to comprehensively assess the plasma exposure levels of these agents, the development of a rapid and highly sensitive bioanalytical method becomes imperative. The primary objective of this study was to establish a robust high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method for the concurrent quantification of mirabegron and vibegron in human plasma. The analytes were extracted from a 100 µL plasma sample through protein precipitation, employing 300 µL of methanol. Subsequently, samples underwent separation and quantification using a Waters XBridge C18 column (2.1 × 100 mm, 3.5 µm), with a mobile phase consisting of 0.1% formic acid in water and 0.1% formic acid in acetonitrile. The mass analysis was conducted using positive electrospray ionization (ESI+) operated in a multiple reaction monitoring (MRM) mode. The proposed method was meticulously validated in accordance with the guidelines set forth by the U.S. Food and Drug Administration (FDA) for bioanalytical method validation. The regression equations demonstrated exceptional linearity for both mirabegron (r² ≥ 0.994) and vibegron (r² ≥ 0.996) across the concentration range of 0.5 - 200 ng/mL. Furthermore, the assay exhibited accuracy (inter-day relative error ≤ 6.90%) and precision (inter-day coefficient of variation ≤ 8.88%). The average recoveries of the analytes were found to range from 81.94% to 102.02%, with mean matrix effects falling within the range of 89.77% to 110.58%. As a result, this method was deemed highly suitable for the precise determination of the concentrations of both mirabegron and vibegron in the context of therapeutic drug monitoring and bioequivalence studies.

Effects of the CYP3A inhibitors, voriconazole, itraconazole, and fluconazole on the pharmacokinetics of osimertinib in rats.

Background: Osimertinib, as third-generation epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI), is the first-line treatment approved to treat advanced T790M mutation-positive tumors. Triazole antifungals are therapeutic drugs for cancer patients to reduce the risk of opportunistic fungal infections. Our objective was to investigate whether three triazole antifungals (voriconazole, itraconazole, and fluconazole) could change the pharmacokinetics of osimertinib in rats. Methods: The adult male Sprague-Dawley rats were randomly divided into four groups (n = 6): control (0.3% CMC-Na), and voriconazole (20 mg/kg), itraconazole (20 mg/kg), or fluconazole (20 mg/kg) combined with osimertinib (10 mg/kg) group. Tail vein blood samples were collected into heparin tubes at various time points within 0-48 h after osimertinib administration. Osimrtinib's plasma concentration was detected using HPLC-MS/MS system equipped with a Waters XBridge C18 column, with the mobile phase consisting of acetonitrile and 0.2% formic acid water at a flow rate of 0.5 mL/min. Results: Co-administration with voriconazole or fluconazole increased the Cmax of osimertinib by 58.04% and 53.45%, respectively; the AUC0-t increased by 62.56% and 100.98%, respectively. However, when co-administered with itraconazole, the Cmax and AUC0-t of osimertinib only increased by 13.91% and 34.80%, respectively. Conclusions: Our results revealed that the pharmacokinetics of osimertinib were significantly changed by voriconazole and fluconazole in rats, whereas it was slightly affected by itraconazole. This work will contribute to a more comprehensive understanding of the pharmacokinetic properties of osimertinib when co-administered with triazole antifungals.

Placing steroid hormones within the human ABCC3 transporter reveals a compatible amphiphilic substrate-binding pocket.

The human ABC transporter ABCC3 (also known as MRP3) transports a wide spectrum of substrates, including endogenous metabolites and exogenous drugs. Accordingly, it participates in multiple physiological processes and is involved in diverse human diseases such as intrahepatic cholestasis of pregnancy, which is caused by the intracellular accumulation of bile acids and estrogens. Here, we report three cryogenic electron microscopy structures of ABCC3: in the apo-form and in complexed forms bound to either the conjugated sex hormones ß-estradiol 17-(ß-D-glucuronide) and dehydroepiandrosterone sulfate. For both hormones, the steroid nuclei that superimpose against each other occupy the hydrophobic center of the transport cavity, whereas the two conjugation groups are separated and fixed by the hydrophilic patches in two transmembrane domains. Structural analysis combined with site-directed mutagenesis and ATPase activity assays revealed that ABCC3 possesses an amphiphilic substrate-binding pocket able to hold either conjugated hormone in an asymmetric pattern. These data build on consensus features of the substrate-binding pocket of MRPs and provide a structural platform for the rational design of inhibitors.

Rare benign liver tumors that require differentiation from hepatocellular carcinoma: focus on diagnosis and treatment.

BACKGROUND/AIM: Recently, an increase in the number of asymptomatic rare benign liver tumors (BLTs) has been reported during health check-ups. It is difficult to determine the nature of partial rare BLTs and not easy to distinguish from malignant liver tumors. This study aimed to analysis clinical features, diagnosis and treatment of rare BLTs to reduce misdiagnosis and provide reference for clinical practice. METHODS: From January 2012 to January 2021, we treated 112 rare BLTs by hepatectomy, including 54 focal nodular hyperplasias, 14 hepatocellular adenomas, 28 hepatic angiomyolipomas, 3 hepatic granulomas, 2 inflammatory pseudotumors of the liver, 2 nodular regenerative hyperplasia, 2 hepatic lipomas, 1 solitary fibrous tumor of the liver, 1 hepatic schwannoma and 1 hepatic myelolipoma. RESULTS: The majority of patients were middle-aged female and asymptomatic. Single tumors were dominant. The diagnostic accuracies of computed tomography (CT) and magnetic resonance imaging (MRI) were 32.5% and 44.2%, respectively. The majority of tumors were likely to be misdiagnosed as hepatocellular carcinoma (HCC) or difficult to distinguish from HCC. All patients underwent surgical treatment. Postoperative pathological and immunohistochemical examination can confirm the diagnosis. No patients without tumor recurrence or metastasis during follow-up period. CONCLUSION: Altogether, the clinical symptoms of rare BLTs lack specificity, and their preoperative diagnosis largely depends on imaging examination, with a low diagnostic accuracy rate and high chances of misdiagnosis as HCC. Diagnosis is confirmed by pathological and immunohistochemical examination. Surgical resection for rare BLT is safe and effective, regular postoperative follow-up is necessary.

Promoting Healthcare Workers' Adoption Intention of Artificial-Intelligence-Assisted Diagnosis and Treatment: The Chain Mediation of Social Influence and Human-Computer Trust.

Artificial intelligence (AI)-assisted diagnosis and treatment could expand the medical scenarios and augment work efficiency and accuracy. However, factors influencing healthcare workers' adoption intention of AI-assisted diagnosis and treatment are not well-understood. This study conducted a cross-sectional study of 343 dental healthcare workers from tertiary hospitals and secondary hospitals in Anhui Province. The obtained data were analyzed using structural equation modeling. The results showed that performance expectancy and effort expectancy were both positively related to healthcare workers' adoption intention of AI-assisted diagnosis and treatment. Social influence and human-computer trust, respectively, mediated the relationship between expectancy (performance expectancy and effort expectancy) and healthcare workers' adoption intention of AI-assisted diagnosis and treatment. Furthermore, social influence and human-computer trust played a chain mediation role between expectancy and healthcare workers' adoption intention of AI-assisted diagnosis and treatment. Our study provided novel insights into the path mechanism of healthcare workers' adoption intention of AI-assisted diagnosis and treatment.

Leaders' innovation expectation and nurses' innovation behaviour in conjunction with artificial intelligence: The chain mediation of job control and creative self-efficacy.

AIM: The aim of this work is to investigate the influence of leaders' innovation expectation on nurses' innovation behaviour in conjunction with artificial intelligence, as well as explore the chain mediating effect of job control and creative self-efficacy between leaders' innovation expectation and nurses' innovation behaviour. BACKGROUND: The nurses' innovation behaviour is crucial in promoting medical artificial intelligence. Thus, clarifying the influencing factors of nurses' innovation behaviour has become a priority. METHODS: A cross-sectional survey was conducted with 263 Chinese nurses from tertiary hospitals and secondary hospitals in Hefei, Anhui province. RESULTS: Leaders' innovation expectation was positively related to nurses' innovation behaviour. Creative self-efficacy and job control respectively mediated the relationship between leaders' innovation expectation and nurses' innovation behaviour. Furthermore, creative self-efficacy and job control played a chain mediation role between leaders' innovation expectation and nurses' innovation behaviour. CONCLUSION: Leaders' innovation expectation helps to enhance nurses' creative self-efficacy and job control, thereby enhancing nurses' enthusiasm for innovation. IMPLICATIONS FOR NURSING MANAGEMENT: Hospital managers and leaders formulate intervention measures to increase leaders' innovation expectation, nurses' creative self-efficacy and job control, and encourage nurses' innovation behaviour.

Structural basis of substrate recognition and translocation by human very long-chain fatty acid transporter ABCD1.

Human ABC transporter ABCD1 transports very long-chain fatty acids from cytosol to peroxisome for ß-oxidation, dysfunction of which usually causes the X-linked adrenoleukodystrophy (X-ALD). Here, we report three cryogenic electron microscopy structures of ABCD1: the apo-form, substrate- and ATP-bound forms. Distinct from what was seen in the previously reported ABC transporters, the two symmetric molecules of behenoyl coenzyme A (C22:0-CoA) cooperatively bind to the transmembrane domains (TMDs). For each C22:0-CoA, the hydrophilic 3'-phospho-ADP moiety of CoA portion inserts into one TMD, with the succeeding pantothenate and cysteamine moiety crossing the inter-domain cavity, whereas the hydrophobic fatty acyl chain extends to the opposite TMD. Structural analysis combined with biochemical assays illustrates snapshots of ABCD1-mediated substrate transport cycle. It advances our understanding on the selective oxidation of fatty acids and molecular pathology of X-ALD.

Structural insights into the activation of autoinhibited human lipid flippase ATP8B1 upon substrate binding.

SignificanceATP8B1 is a P4 ATPase that maintains membrane asymmetry by transporting phospholipids across the cell membrane. Disturbance of lipid asymmetry will lead to the imbalance of the cell membrane and eventually, cell death. Thus, defects in ATP8B1 are usually associated with severe human diseases, such as intrahepatic cholestasis. The present structures of ATP8B1 complexed with its auxiliary noncatalytic partners CDC50A and CDC50B reveal an autoinhibited state of ATP8B1 that could be released upon substrate binding. Moreover, release of this autoinhibition could be facilitated by the bile acids, which are key factors that alter the membrane asymmetry of hepatocytes. This enabled us to figure out a feedback loop of bile acids and lipids across the cell membrane.

Exploring the effect of three scaffoldings on the collaborative problem-solving processes in China's higher education.

Collaborative problem-solving (CPS) engages students in solving ill-structured problems, creating group knowledge, and developing self-regulation and collaboration skills. Different scaffoldings, such as minimal-guided, task-oriented, and idea-oriented, can be used to facilitate students' CPS activities, but their effects have not been comprehensively explored. In this research, we use minimally-guided, task-oriented, and idea-oriented scaffoldings to promote Chinese university students' online CPS activities and use a multi-method approach to analyze the effects of three scaffolding on collaboration. The results indicate relatively complicated collaborative processes and outcomes supported by three scaffoldings. It is initially shown that the idea-centered scaffolding strengthens students' connections between idea contribution, metacognitive regulation, and knowledge artifact behaviors, which are critical factors for improving the CPS quality. Based on the empirical research results, we conclude that future instructional design should carefully consider the educational culture, time constraint, and student regulation to better facilitate CPS practices.

New Insights into the Mechanisms of Polyphenol from Plum Fruit Inducing Apoptosis in Human Lung Cancer A549 Cells Via PI3K/AKT/FOXO1 Pathway.

Recent studies have been found that polyphenols from plums fruits can inhibit the proliferation of multiple cancer cells, while the molecular mechanism was unclear. This study aimed to investigate the molecular mechanism underlying the pro-apoptotic effect of purified plum polyphenols (PPP) on human lung cancer A549 cells. Quercitrin (quercetin-3-O-glucoside, 814.19 ± 40.71 mg/g) was identified as the primary polyphenol in PPP via ultra high-performance liquid chromatography coupled with triple quadrupole mass spectrometry (UHPLC-QqQ-MS/MS). PPP showed a strong capacity for inhibiting the proliferation of the A549 cells by inducing apoptosis, which was reflected by an increase in the Bax/Bcl-2 ratio. Additionally, the inhibitory rate of PPP on the A549 cells were higher than that of vitamin C when the treatment dose exceeded 160 µg/mL. Transcriptome analysis suggested that PPP-induced apoptosis was closely associated with regulating the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT)/forkhead box protein O 1 (FOXO1) pathway in the A549 cells. Subsequently, as an activator of AKT, SC79 was applied to confirm that the inhibition of AKT phosphorylation play an important role in the PPP-induced apoptosis of the A549 cells. These results illustrated the potential of PPP as a dietary compound for the prevention of cancer or for use during chemotherapy.

Representative survey on idiopathic environmental intolerance attributed to electromagnetic fields in Taiwan and comparison with the international literature.

BACKGROUND: Electromagnetic hypersensitivity refers to health effects attributed to electromagnetic fields (EMF) exposure and has been formally named "idiopathic environmental intolerance attributed to electromagnetic fields" (IEI-EMF) by the World Health Organization. Because of the growing use of cell phones, IEI-EMF has become a global public health concern. A survey in 2007 in Taiwan showed that the prevalence rate of IEI-EMF was 13.3%, which is higher than rates in studies conducted previously. The survey also found that the rate was higher in women. METHODS: To evaluate whether the prevalence rate of IEI-EMF is increasing and to verify the higher risk in women, we conducted a nationwide questionnaire survey using the same methods as the 2007 survey to assess the change in the prevalence rate of IEI-EMF in Taiwan. We also conducted a review of the literature and a meta-analysis to evaluate the changes in the prevalence rate around the world. RESULTS: On the basis of the representative sample of 3303 participants, we found that the prevalence rate of IEI-EMF in Taiwan declined from 13.3% to 4.6% over a period of 5 years. The literature review also found the prevalence rates in other countries to be decreasing, instead of increasing as predicted previously. The meta-analysis of the data from the literature showed that women are more likely to have IEI-EMF than men, with an odds ratio of 1.19 (95% confidence interval: 1.01-1.40). CONCLUSIONS: We found the prevalence rate of IEI-EMF has been declining, instead of increasing as predicted previously. Women are more likely to report having IEI-EMF than men. Further studies to explore the causes leading to the declines may help the public, scientific community, and government deal with idiopathic intolerance to other environmental exposures.

Structure of a MacAB-like efflux pump from Streptococcus pneumoniae.

The spr0693-spr0694-spr0695 operon of Streptococcus pneumoniae encodes a putative ATP-binding cassette (ABC)-type efflux pump involved in the resistance of antibiotics and antimicrobial peptides. Here we report the crystal structures of Spr0694-0695 at 3.3 Å and Spr0693 at 3.0 Å resolution, revealing a MacAB-like efflux pump. The dimeric Spr0694-0695 adopts a non-canonical fold of ABC transporter, the transmembrane domain of which consists of eight tightly packed transmembrane helices with an insertion of extracellular domain between the first and second helices, whereas Spr0693 forms a nanotube channel docked onto the ABC transporter. Structural analyses combined with ATPase activity and antimicrobial susceptibility assays, enable us to propose a putative substrate-entrance tunnel with a lateral access controlled by a guard helix. Altogether, our findings provide structural insights and putative transport mechanism of a MacAB-like efflux pump in Gram-positive bacteria.

A Disintegrin and Metalloproteinase with Thrombospondin Motifs 18 Deficiency Leads to Visceral Adiposity and Associated Metabolic Syndrome in Mice.

Visceral adiposity is of greater risk than obesity in s.c. adipose tissue for diabetes and cardiovascular disease. Its pathogenesis remains unclear, but it is associated with extracellular matrix (ECM) remodeling. A disintegrin and metalloproteinase with thrombospondin motifs (ADAMTSs) are a family of secreted zinc-dependent metalloproteinases that play crucial roles in development and various diseases because of their ECM remodeling activity. ADAMTS18 is an orphan ADAMTS whose function and substrate remain unclear. Herein, we showed that Adamts18 mRNA was abundantly expressed in visceral (gonadal) white adipose tissue (vWAT) during the early stage of development after birth. Adamts18 knockout (KO) mice showed increased body fat percentage and larger adipocyte size in vWAT relative to wild-type littermates. These findings may be partly attributed to ECM remodeling, especially increased expression of laminin 1 and adipokine thrombospondin 1 in vWAT. Attenuated extracellular signal-regulated kinase 1 and 2 activity, along with increased expression of adipocyte-specific transcription factors peroxisome proliferator-activated receptor-γ, CCAAT/enhancer binding protein ß, and marker gene Fabp4, was detected in vWAT of Adamts18 KO mice. Furthermore, Adamts18 KO mice showed early metabolic syndrome, including hyperlipidemia, blood glucose metabolic disorder, and hypertension. ADAMTS18 deficiency promotes atherosclerosis in apolipoprotein E-deficient mice. These results indicate a novel function of ADAMTS18 in vWAT development and associated metabolic disorders.

The development of monoclonal anti-ADAMTS18 antibodies with precise validation of ADAMTS18 post-translational modification status in living organisms.

ADAMTS18 is a member of a secreted Zn-metalloproteinase ADAMTS family, and has been implicated in development, hemostasis, and various malignancies. It has thus far proven difficult to resolve its post-translational modification status, cleaved forms, and splice variants in living organisms due to the lack of specific antibodies available to characterize this enzyme. In this study, we develop six murine monoclonal antibodies (mAbs) against different functional regions of ADAMTS18 using hybridoma technology. These mAbs exhibit cross-recognition between ADAMTS18 and the homology domain of its family members. Using the tissues from Adamts18 knockout (KO) mice, we find that two of these mAbs (N-3 and C-5) precisely identify five significantly attenuated bands located at 180, 135, 95, 72, and 45 kDa. These bands represent the forms of ADAMTS18 that potentially exist in the tissues. These mAbs will provide a useful tool to investigate the ADAMTS18's biologic significance in the tissues.

Involvement of WNK1-mediated potassium channels in the sexual dimorphism of blood pressure.

Potassium homeostasis plays an essential role in the control of blood pressure. It is unknown, however, whether potassium balance is involved in the gender-associated blood pressure differences. We therefore investigated the possible mechanism of sexual dimorphism in blood pressure regulation by measuring the blood pressure, plasma potassium, renal actions of potassium channels and upstream regulator in male and female mice. Here we found that female mice exhibited lower blood pressure and higher plasma K+ level as compared to male littermates. Western blot analyses of mouse kidney extract revealed a significant decrease in renal outer medullary potassium (ROMK) channel expression, while large-conductance Ca2+-activated K+ (BK) channel and Na-K-2Cl cotransporter (NKCC2) as well as the upstream regulator with-no-lysine kinase 1 (WNK1) enhanced in female mice under normal condition. Surprisingly, both dietary K+ loading and K+ depletion eliminated the differences in plasma K+ and blood pressure between females and males, and the differences of renal K+ channels and WNK1 also attenuated in both groups of mice. These findings indicated the existence of a close correlation between K+ homeostasis and sex-associated blood pressure. Moreover, the differential regulation of ROMK, BK-α and NKCC2 between female and male mice, at least, were partly mediated via WNK1 pathway, which may contribute to the sexual dimorphism of plasma K+ and blood pressure control.

Graphene oxide nanoribbons: improved synthesis and application in MALDI mass spectrometry.

Graphene nanoribbon is a novel variety of graphene with high length-to-width ratio and straight edges. Herein, we report an improved method for the synthesis of graphene oxide nanoribbons (GONRs) from longitudinal unraveling of multiwalled carbon nanotubes by means of a one-step, one-pot pressurized oxidation reaction. The obtained GONRs were characterized by different techniques. Furthermore, owing to their unique properties such as strong optical absorption and good water dispersibility, we show that GONRs can be used as an excellent matrix or probe in matrix-assisted or surface-enhanced laser desorption/ionization mass spectrometry (MALDI or SELDI MS) for the first time. In MALDI MS, GONRs generated significantly higher signals than conventional organic matrix and other graphene-based matrices in the detection of low-mass compounds. We also demonstrate the use of GONRs as a sensitive SELDI probe for simultaneous detection of multiple small molecules and profiling of small molecules in complex environmental samples, thus revealing its application potential in rapid screening of low-mass pollutants in complex media.

An antibody-graphene oxide nanoribbon conjugate as a surface enhanced laser desorption/ionization probe with high sensitivity and selectivity.

Graphene oxide nanoribbons (GONRs) were covalently functionalized with an antibody using polyethylene glycol (PEG) as a linker to produce a novel probe for surface enhanced laser desorption/ionization mass spectrometry (SELDI MS). This probe provides a highly sensitive and selective platform for enrichment and MS detection of small molecules in complex media.

Graphenized pencil lead fiber: facile preparation and application in solid-phase microextraction.

Graphenized pencil lead fiber was facilely prepared by in situ chemical exfoliation of graphite in pencil lead fiber to few-layered graphene sheets via a one-pot, one-step pressurized oxidation reaction for the first time. This new fiber was characterized and demonstrated to be a highly efficient but low-cost solid-phase microextraction (SPME) fiber. The extraction performance of the fiber was evaluated with four bisphenol analogs [bisphenol A (BPA), bisphenol S (BPS), bisphenol AF (BPAF), and tetrabromobisphenol A (TBBPA)] as model analytes in direct SPME mode. Unlike commercially available fibers, the graphenized pencil lead fiber showed an excellent chemical stability in highly saline, acidic, alkaline and organic conditions due to its coating-free configuration. The fiber also showed a very long lifespan. Furthermore, high extraction efficiency and good selectivity for the analytes with a wide polarity range could be obtained due to the exceptional properties of graphene. The detection limits (LODs) for the analytes were in the range of 1.1-25ng/L. The fiber was successfully applied in the analysis of tap water and effluent samples from a waste water treatment plant with spike recoveries ranging from 68.5 to 105.1%. Therefore, the graphenized pencil lead fiber provides a high performance, cheap, robust, and reliable tool for SPME.

Mildly oxidized graphene: facile synthesis, characterization, and application as a matrix in MALDI mass spectrometry.

To be mild! Mild oxidization of chemically converted graphene with diluted nitric acid produces low-oxidation and low-defect acid-oxidized graphene (AOG) material with excellent water dispersibility. In MALDI MS, the AOG matrix yielded significantly higher signals than graphene, graphene oxide, and conventional organic matrices for nonpolar analytes.

Preparation of graphene-encapsulated magnetic microspheres for protein/peptide enrichment and MALDI-TOF MS analysis.

The Fe(3)O(4)@SiO(2)@graphene microspheres were prepared and demonstrated to be highly efficient enrichment materials for proteins and peptides in MALDI-TOF MS analysis.