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Although current quality indicators of colonoscopy recommend 6 minutes as the minimum standard for withdrawal time (WT), the impact of a WT longer than 6 minutes on neoplasia detection is unclear. A multicenter randomized controlled trial involving 1027 patients was conducted from January 2018 to July 2019. Participants were randomly divided into a 9-minute (n = 514) and 6-minute (n = 513) WT group, and a timer was used to adjust the withdrawal speed. The primary outcome was the adenoma detection rate (ADR). Intention-to-treat analysis showed a significantly higher ADR in the 9-minute versus 6-minute WT group (36.6% vs. 27.1%, P =.001). Prolonging WT from 6 to 9 minutes significantly increased ADR of the proximal colon (21.4% vs. 11.9%, P <.001) as well as of the less experienced colonoscopists (36.8% vs. 23.5%, P =.001). Improvements were also observed in the polyp detection rate (58.0% vs. 47.8%, P <.001), and mean number of polyps and adenomas detected per colonoscopy (1.1 vs. 0.9, P =.002; 0.5 vs. 0.4, P =.008, respectively). The higher ADRs in 9-minute WT were also confirmed by the per-protocol (PP) analysis and subgroup analyses, with an increased rate of sessile serrated lesion detection in the 9-minute WT by PP analysis (4.0% vs. 1.3%, P =.04). Multivariate logistic regression demonstrated that the 9-minute WT was independently associated with increased ADR (P =.005). Prolonging WT from 6 to 9 minutes significantly improved ADR, especially in the proximal colon and for less experienced colonoscopists. A 9-minute WT benchmark should be considered as one of the quality indicators of colonoscopy. ClinicalTrials.gov (identifier, NCT03399045) [Display omitted] [ABSTRACT FROM AUTHOR]

To explore the optimal combination of monochromatic images derived from dual-energy CT (DECT) in calculating the stopping power ratio (SPR) of human tissues. Monochromatic CT numbers ranging from 40 keV to 140 keV (in intervals of 10 keV) for 34 standard human tissues were theoretically computed based on the NIST database. These values were then paired, resulting in 55 different dual-energy combinations for calculating the stopping power ratio (SPR). The combinations adhered to the rule of a lower energy (E low) paired with a higher X-ray energy (E high). Subsequently, each energy combination was utilized to predict the SPR of human tissues, and the accuracy of each pairing was assessed. Additionally, an analysis of the impact of uncertainty in the attenuation coefficient was conducted. When E low is ≤ 70 keV, an optimal energy combination emerges. These optimal energy combinations within the 40 keV, 50 keV, 60 keV, and 70 keV groups are 40–100 keV, 50–90 keV, 60–80 keV, and 70–80 keV, respectively, with corresponding mean absolute errors (MAE) of SPR at 0.12%, 0.11%, 0.12%, and 0.15%, respectively. The impact of attenuation coefficient uncertainty on these findings is minimal; even with a 1–2% uncertainty, the maximum change in MAE for SPR error is only 0.04%. Dual-energy CT utilizing energy pairs within the low energy range (40–70 keV) exhibits greater advantages in predicting the stopping power ratio of human tissues. In our investigation, the four energy combinations—40-100 keV, 50–90 keV, 60–80 keV, and 70-80 keV—demonstrated the highest accuracy in predicting SPR. • Reconstructed monochromatic CT numbers of materials using NIST database. • There is optimal energy combination when predicting the proton range by DECT. • 40–100 keV, 50–90 keV, 60–80 keV and 70–80 keV have the best SPR prediction accuracy. [ABSTRACT FROM AUTHOR]

Eight new ent -kaurane diterpene fatty acid esters, namely caffarolides A–H ( 1 – 8 ), were isolated from green beans of Coffea arabica . Their chemical structures were confirmed by extensive spectroscopic analysis including 1D, 2D NMR (HSQC, HMBC, 1 H– 1 H COSY, and ROESY), HRMS, IR and CD spectra and by GC-FID analysis. Interestingly, the diterpene moiety of these new compounds first occurred in genus Coffea . All the isolates were evaluated for platelet aggregation activity in vitro . As the results, caffarolides C, D and F ( 3 , 4 and 6 ) showed induction effect for platelet aggregation and the possible structure-activity relationships have been discussed briefly. [ABSTRACT FROM AUTHOR]

Colonoscopy insertion is painful for some patients and is one of the main barriers to screening colonoscopy. Few studies have assessed the impact of the supine position (SP) on colonoscopy insertion, especially for unsedated patients. The aim of this randomized controlled trial was to clarify this issue. Unsedated patients were randomized to SP or left horizontal position (LHP) as the starting position of colonoscopy insertion. The primary outcome measure was cecal intubation time (CIT), and the secondary outcome measures were descending colon intubation time (DIT), pain score of patients, difficulty score according to the endoscopist, and patients' acceptance of unsedated colonoscopy. A total of 347 patients were randomized to the SP group (175) or the LHP group (172). The CIT in the SP group was significantly shorter than that in the LHP group (275.0 seconds [interquartile range (IQR), 234.0-328.5 seconds] versus 316.0 seconds [IQR, 261.0-370.0 seconds], P <.001). The DIT was also shorter in the SP group (64.5 seconds [IQR, 52.0-86.3 seconds] versus 74.0 seconds [IQR, 62.0-92.0 seconds], P =.001). Compared with the LHP, the SP had a lower pain score (3.3 versus 3.9, P =.002), a lower difficulty score (3.1 versus 3.7, P <.001), a lower frequency of position change (7.1% versus 38.0%, P <.001), and less need for abdominal compression (39.1% versus 45.5%, P =.02). SP was the only modifiable and independent factor identified to reduce CIT and pain score and improve patients' acceptance of unsedated colonoscopy. As an economical and convenient method, SP can reduce CIT, ease pain, and improve patients' acceptance of unsedated colonoscopy. (Clinical trial registration number: NCT03289442.) [ABSTRACT FROM AUTHOR]

Background & Aims We performed a systematic review and meta-analysis to comprehensively estimate adenoma miss rate (AMR) and advanced AMR (AAMR) and explore associated factors. Methods We searched the PubMed, Web of Science, and Ovid EMBASE databases for studies published through April 2018 on tandem colonoscopies, with AMR and AAMR as the primary outcomes. We performed meta-regression analyses to identify risk factors and factors associated with outcome. Primary outcomes were AMR and AAMR and secondary outcomes were AMR and AAMR for different locations, sizes, pathologies, morphologies, and populations. Results In a meta-analysis of 43 publications and more than 15,000 tandem colonoscopies, we calculated miss rates of 26% for adenomas (95% confidence interval [CI] 23%–30%), 9% for advanced adenomas (95% CI 4%–16%), and 27% for serrated polyps (95% CI 16%–40%). Miss rates were high for proximal advanced adenomas (14%; 95% CI 5%–26%), serrated polyps (27%; 95% CI 16%–40%), flat adenomas (34%; 95% CI 24%–45%), and in patients at high risk for colorectal cancer (33%; 95% CI 26%–41%). Miss rates could be decreased by adequate bowel preparation and auxiliary techniques (P =.06; P =.04, and P =.01, respectively). The adenoma detection rate (ADR), adenomas per index colonoscopy, and adenomas per positive index colonoscopy (APPC) were independently associated with AMR (P =.02, P =.01, and P =.008, respectively), whereas APPC was the only factor independently associated with AAMR (P =.006). An APPC value greater than 1.8 was more effective in monitoring AMR (31% vs 15% for AMR P <.0001) than an ADR value of at least 34% (27% vs 17% for AMR; P =.008). The AAMR of colonoscopies with an APPC value below 1.7 was 35%, vs 2% for colonoscopies with an APPC value of at least 1.7 (P =.0005). Conclusions In a systematic review and meta-analysis, we found that adenomas and advanced adenomas are missed (based on AMR and AAMR) more frequently than previously believed. In addition to ADR, APPC deserves consideration as a complementary indicator of colonoscopy quality, if it is validated in additional studies. Graphical abstract [ABSTRACT FROM AUTHOR]

Increased endoplasmic reticulum (ER) stress has emerged as a vital contributor to dysregulated glucose homeostasis, and impaired function of sarco-endoplasmic reticulum Ca 2+ -ATPase 2b (SERCA2b) is one of the central mechanisms underlying ER stress. In this study, we reported that SERCA2b upregulation contributed to the amelioration of ER stress and insulin resistance by a small natural compound jaceosidin. In a model of differentiated C2C12 myotubes, jaceosidin-triggered SERCA2b upregulation enhanced insulin sensitivity and decreased ER stress. Moreover, the activity of Ca 2+ -ATPase in thapsigargin-treated myotubes was also augmented by jaceosidin. Furthermore, jaceosidin significantly suppressed blood glucose levels, improved glucose tolerance and lowered body weight, but did not alter food intake in insulin-resistant obese mice. In addition, this compound markedly reduced lipid accumulation, suppressed the expression of lipogenic genes in liver and ameliorated liver injury. The ameliorative effects of jaceosidin were due to its ability to reduce ER stress via increasing the expression of SERCA2b in the muscles of obese mice. Taken together, jaceosidin could improve ER stress and attenuate insulin resistance via SERCA2b upregulation in mice skeletal muscles. [ABSTRACT FROM AUTHOR]

Azadirachtin as a kind of botanical insecticide has been widely used in pest control. We previously reported that azadirachtin could induce apoptosis of Spodoptera litura cultured cell line Sl-1, which involves in the up-regulation of P53 protein. However, the detailed mechanism of azadirachtin-induced apoptosis is not clearly understood in insect cultured cells. The aim of the present study was to address the involvement of lysosome and lysosomal protease in azadirachtin-induced apoptosis in Sf9 cells. The result confirmed that azadirachtin indeed inhibited proliferation and induced apoptosis. The lysosomes were divided into different types as time-dependent manner, which suggested that changes of lysosomes were necessarily physiological processes in azadirachtin-induced apoptosis in Sf9 cells. Interestingly, we noticed that azadirachtin could trigger lysosomal membrane permeabilization and cathepsin L releasing to cytosol. Z-FF-FMK (a cathepsin L inhibitor), but not CA-074me (a cathepsin B inhibitor), could effectively hinder the apoptosis induced by azadirachtin in Sf9 cells. Meanwhile, the activity of caspase-3 could also be inactivated by the inhibition of cathepsin L enzymatic activity induced by Z-FF-FMK. Taken together, our findings suggest that azadirachtin could induce apoptosis in Sf9 cells in a lysosomal pathway, and cathepsin L plays a pro-apoptosis role in this process through releasing to cytosol and activating caspase-3. [ABSTRACT FROM AUTHOR]

Graphical abstract Highlights • A computational approach was developed to identify dysregulated lncRNA-involved FFLs in breast cancer subtypes. • We investigated the common and specific FFLs in breast cancer subtypes. • We identified the survival-associated FFLs and the potential drugs for breast cancer subtypes. Abstract Previous studies have demonstrated that transcription factor-miRNA-gene feed-forward loops (FFLs) played important roles in tumorigenesis. However, the lncRNA-involved FFLs have not been explored very well. Understanding the characteristics of lncRNA-involved FFLs in breast cancer subtypes may be a key question with clinical implications. In this study, we firstly constructed an integrated background regulatory network. Then, based on mRNA, miRNA, and lncRNA differential expression, we identified 147, 140, 284, 1031 dysregulated FFLs for luminal A, luminal B, HER2+ and basal-like subtype of breast cancer, respectively. Importantly, the known breast cancer-associated lncRNAs and miRNAs were enriched in the identified dysregulated FFLs. Through merging the dysregulated FFLs, we constructed the regulatory sub-network for each subtype. We found that all sub-networks were enriched in the well-known cancer-related pathways, such as ce ll cycle , pathways in cancer. Next, we also identified potential prognostic FFLs for subtypes of breast cancer, such as the hsa-miR-182-5p_JUN_XIST in basal-like subtype. Finally, we also discussed the potential application of inferring the candidate drugs for breast cancer treatment through modulating the lncRNA expression in the dysregulated FFLs. Collectively, this study elucidated the roles of lncRNA-involved FFLs in breast cancer subtypes, which could contribute to understanding breast cancer pathogenesis and improving the treatment. [ABSTRACT FROM AUTHOR]

Ferrous sulfide produced by rust sulfuration in crude oil tank can cause accidents such as fire and explosion when exposed to air. It is quite difficult to determine the specific location of the sulfur corrosion products in crude oil tanks as well as to acquire for laboratory testing. Thus, ferrous sulfide with high spontaneous combustion activity is a good alternative for continuing the research of sulfur corrosion products. In this study, pyrophoric active ferrous sulfide sample was synthesized in laboratory. The synthetic sample was studied by X-ray diffraction (XRD), scanning electron microscopy (SEM) combined with energy dispersive spectrometer (EDS), electron probe microanalysis (EPMA) and thermal analysis (TA), respectively. The tests indicated that the synthetic sample was amorphous flocculent agglomerate and the atomic ratio of Fe and S was 1:1 approximately, and the oxidative product was mainly Fe 2 O 3 . Non-isothermal calorimetric experiments were conducted with different heating rates. The reaction atmosphere was hypoxic with a 5:95% oxygen:nitrogen gas mix. Apparent activation energy was estimated based on iso-conversional methods. It would benefit for safety on petrochemical industries such as monitoring and early warning of fire and explosion of oil tanks caused by ferrous sulfide with the obtained parameters. [ABSTRACT FROM AUTHOR]

To investigate the effect of equivalent uniform dose (EUD)-based optimization on radiotherapy planning for left-sided breast cancer after mastectomy. Twelve patients treated with left-sided breast cancer using volumetric modulated arc therapy (VMAT) were retrospectively enrolled in this study. Four plans were generated for each patient. Plan A was optimized based on only physical parameters. EUD with α > 0 to organ at risk (OARs) was added in Plan B on the basis of Plan A; EUD with α < 0 to planning tumor volume (PTV) was added in Plan C on the basis of Plan A; EUD constraints were added for both OARs and PTV in Plan D. The quality of plans was evaluated in terms of V x (volume percent of PTV or OARs received xGy dose), D x (dose received by volume above x% of PTV or OARs), conformity index (CI), mean dose (D mean), maximum dose (D max) and minimum dose (D min). For PTV: Plan A vs. Plan B, the difference of D 2 and CI was statistically significant (P < 0.05); Plan A vs. Plan C, the differences in D 98 , D mean and HI were statistically significant (P < 0.05); Plan A vs. Plan D, differences in D 2 , D mean and HI were statistically significant (P < 0.05). For OARs: Plan A vs. Plan B, and Plan A vs. Plan D, the differences in V 5 , V 10 , V 20 , V 30 , D mean of the left lung and V 10 , V 20 , V 30 , D mean of the heart were statistically significant (P < 0.05), the differences in D mean of the thyroid and contralateral breast and the D 2 and D max of spinal cord and spinal cord planning risk volume (PRV) were statistically significant (P < 0.05); Plan A vs. Plan C, only the difference in D max of spinal cord was statistically significant (P < 0.05). Compared with DV condition, the dosimetric data with EUD-based optimization for OARs and PTV confer advantages in terms of the mean dose region of the left lung, heart, thyroid and contralateral (right) breast and the maximum dose of the spinal cord, and the improvement of the conformity and homogeneity of the target. • VMAT plans shows advantage in radiotherapy for left-sided breast cancer. • EUD-based VMAT optimization for left-sided breast cancer was studied firstly. • EUD optimization remedies the defects of DV function. • Results show conformity and homogeneity of target were promoted by using EUD. • OARs were protected based on the EUD optimization. [ABSTRACT FROM AUTHOR]

It is still a considerable challenge for spinel Li 4 Ti 5 O 12 to achieve high tap density while retaining excellent power capability. Herein, a compact and mesopore-oriented holey-graphene framework (HGF) caging nano-Li 4 Ti 5 O 12 particles (Li 4 Ti 5 O 12 /HGF) is synthesized by capillary shrink effect. In the capillary drying process, nano-Li 4 Ti 5 O 12 particles prevent the absolute aggregation of graphene sheets, remaining mesopore-oriented porosity for rapid Li+ diffusion. After precisely adjusting the porous structure, Li 4 Ti 5 O 12 /HGF composite successfully achieves a balance between tap density and porosity. Furthermore, the in-plane nanopores of holey-graphene sheets provide channels for Li+ diffusion, obviously weakening the Li+ diffusion resistances of compact composite. The resultant Li 4 Ti 5 O 12 /HGF composite combines a high tap density of 1.1 g cm−3 and a moderate mesopore-oriented porosity with BET specific area of 152 m2 g−1, delivering volumetric-specific capacities of 161, 142, 120, 103 mA h cm−3 at 0.035, 1.75, 7 and 14 A g−1, respectively. Even as current density reaches 17.5 A g−1, the as-prepared Li 4 Ti 5 O 12 /HGF composite still displays a capacity of 98 mA h cm−3, showing excellent ultrahigh-rate performance. After 1000 cycles at 7A g−1, the capacity of dense Li 4 Ti 5 O 12 /HGF composite remains 84%, demonstrating high cycle stability. Image 1 • A balance between high tap density and mesopore-oriented structure. • Decreasing Li+ diffusion resistance due to holey-graphene sheets. • Excellent power capability and high cycle stability. [ABSTRACT FROM AUTHOR]