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Abstract Objectives Preterm delivery rates have increased obviously worldwide over the past decade, yet reliable epidemiological studies on the incidence of preterm birth and temporal trends are not available in Hainan, The Free Trade Port in China. We aimed to describe the rate of preterm birth and trends between 2010 and 2021 and to primarily explore risk factors associated with preterm birth in Hainan, China. Methods This was an observational study was based on data from the Hainan Provincial Birth Certificate System (HPBCS) for live births between 1 January 2010 and 31 December 2021. We included pregnancies resulting in at least one live birth, with newborns born at a gestational age of 28 weeks or greater, or with a birth weight of 1000 g or more. The outcome were preterm birth rates and their trends over time. Potential risk factors were collected, including infant gender, maternal age, paternal age, maternal ethnicity, paternal ethnicity, home address, and single or multiple pregnancies. The logistic regression model was used to assess the relationship between preterm birth and potential risk factors. Results A total of 1,537,239 live births and 86,328 preterm births were investigated, giving a total preterm birth rate of 5.62%. The overall preterm birth rate increased from 4.47% in 2010 to 7.12% in 2021 (compound annual growth rate [CAGR] 4.32). The CAGR of late preterm birth is consistent with the overall preterm birth rate (4.32%). The fastest growth is observed in the rate of very preterm births (5.53%), while the rate of moderate preterm births exhibits the slowest growth (3.87%). Infant gender, multiple pregnancy, home address, parental age, and ethnicity had significant effects on preterm birth. Conclusion The preterm birth rate was increasing year by year from 2010 to 2021 in Hainan, The Free Trade Port in China. Incidence of preterm births in Hainan Province in relation to multiple pregnancies, infant sex, parental age, parental race and residential address.

Abstract Background Cell and gene therapy products (CGTPs) often receive accelerated approvals, lacking comprehensive long-term safety and efficacy data, which can raise significant safety concerns. This research aims to study the post-marketing surveillance (PMS) of CGTPs in the European Union (EU), the United States (US), Japan, South Korea, and China, to offer insights for the development of a secure and standardized post-marketing regulatory framework for CGTPs. Methods Related regulations and the implementation effect of PMS for approved CGTPs were studied searching PubMed, CNKI, and the official websites of the European Medicines Agency, the US Food and Drug Administration, Japan’s Pharmaceuticals and Medical Device Agency, South Korea’s Ministry of Food and Drug Safety, and the National Medical Products Administration of China. Results Compared to those in China, the guidelines of PMS for CGTPs in the EU, the US, Japan, and South Korea was more comprehensive. Notably, the EU had dedicated regulations and supporting guidelines of PMS. Of the 26 CGTPs approved in the EU, 88% were under additional monitoring, 38% received conditional marketing authorization, and 12% were authorized under exceptional circumstances, with 77% designated as orphan drugs. The US had released 34 guidelines specifically for CGTPs which, forming the foundation of post-marketing risk management. Among the 27 CGTPs approved in the US, 22% were required to perform risk evaluation and mitigation strategies, 37% added black box warnings in the package inserts, 63% mandated to post-marketing requirements, and 15% subject to post-marketing commitments. In Japan, stringent supervision measures encompassing all-case surveillance (79%) and re-examination (53%) were applied to the 19 approved CGTPs, with 21% approved through conditional and time-limited approval. The PMS for CGTPs in South Korea, mainly included PSUR, re-examination, and re-evaluation. China had introduced several relevant regulations, which consisted of general statements and lacked detailed guidance. Conclusions This study demonstrates that the regulatory policies of PMS for CGTPs in the EU, the US, Japan, and South Korea were comprehensive. The implementation of PMS for CGTPs in the EU, the US, and Japan was well developed. This knowledge holds valuable insights for China’s future learning and development in this field.

Abstract Acute anterior uveitis (AAU) is a common extra‐articular manifestation of ankylosing spondylitis (AS), particularly in patients positive for the human leucocyte antigen (HLA)‐B27 genetic marker. To explore the underlying mechanisms of HLA‐B27+ AS‐associated AAU, we employed single‐cell RNA sequencing to profile the transcriptomes of peripheral blood mononuclear cells in three HLA‐B27+ AS‐associated AAU patients and three healthy controls (HCs). We identified 11 distinct immune cell clusters, with a particular focus on monocytes, revealing six subsets, including three previously unidentified subsets, namely, GTPase immune‐associated proteins, Th17‐related, and lncRNA monocytes, with unique gene expression patterns. Significant differences in monocyte composition, activation states, and gene expression were observed between patients and HCs, particularly within HLA monocyte subpopulations. Notably, enhanced expression of X‐inactive specific transcript and myeloid cell nuclear differentiation antigen genes was validated across monocyte subclusters in patients. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analysis highlighted significant enrichment in antigen processing and presentation pathways, shedding light on the disease's molecular mechanisms. These findings provide novel insights into the molecular mechanisms of HLA‐B27+ AS‐associated AAU and may contribute to the development of targeted diagnostic and therapeutic strategies. Further clinical validation is essential.

As the main type of renal cell carcinoma (RCC), clear cell RCC (ccRCC) is often associated with the deletion or mutation of the von Hippel Lindau (VHL) gene, enhancement of glucose and lipid metabolism, and heterogeneity of the tumor microenvironment. VHL alterations in RCC cells lead to the activation of hypoxia-inducible factors and their downstream target vascular endothelial growth factor, and to the reprogramming of multiple cell death pathways and metabolic weakness, including ferroptosis, which are associated with targeted therapy or immunotherapy. The changes in biological metabolites (e.g., iron and lipids) support ferroptosis as a potential therapeutic strategy for RCC, while iron metabolism and ferroptosis regulation have been examined as anti-RCC agents in numerous studies, and various ferroptosis-related molecules have been shown to be related to the metastasis and prognosis of ccRCC. For example, glutathione peroxidase 4 and glutaminase inhibitors can inhibit pyrimidine synthesis and increase reactive oxygen species levels in VHL-deficient RCC cells. In addition, the release of damage-associated molecular patterns by tumor cells undergoing ferroptosis also mediates antitumor immunity, and immune therapy can synergize with targeted therapy or radiotherapy through ferroptosis. However, Inducing ferroptosis not only suppresses cancer, but also promotes cancer development due to its potential negative effects on anti-cancer immunity. Therefore, ferroptosis and various tumor microenviroment-related molecules may co-occur during the development and treatment of RCC, and further understanding of the interactions, core targets, and related drugs of ferroptosis may provide new combination drug strategies for RCC treatment. Here we summarize the key genes and compounds on ferroptosis and RCC in order to envision future treatment strategies and to provide sufficient information for overcoming RCC resistance through ferroptosis.

Species in the Amorphophallus genus are important cash crops in many tropical and subtropical Asian countries. Although several molecular markers have been employed to determine relationships and assess genetic variation in the Amorphophallus genus, some conflicts remain in infrageneric classification and evolution. To aid in the phylogenetic research of the Amorphophallus genus, we collected one sample of Amorphophallus tonkinensis Engler and Gehrmann 1911 from southwestern China. We assembled the first chloroplast genome of this species using high-throughput sequencing. The assembled genome was 169,341 bp long with a typical quadripartite structure (GenBank accession number: PP234804). The lengths of the large single-copy region, small single-copy region, and two inverted repeats were 90,705 bp, 15,640 bp, 31,498 bp, and 31,498 bp, respectively. We annotated 129 genes across the chloroplast genome of A. tonkinensis. The phylogenetic trees suggested that the Amorphophallus species distributed in continental Asia split into two main clades. The chloroplast genome reported in our study provided valuable genomic resources for the future phylogenetic research of the Amorphophallus genus.

BackgroundIn recent years, the incidence of Endometrial cancer (EC) has been on the rise due to high-fat, high-calorie diets and low-exercise lifestyles. However, the relationships between metabolic disorders and the progression of EC remain uncertain. The purpose of our study was to explore the potential association between obesity, hypertension, hyperglycemia and clinicopathologic characteristics in EC patients.MethodsIn categorical variables, Chi-square tests were used to calculate P values. Univariate logistic regression and multivariate logistic regression were used to identify the risk factors of myometrial invasion>1/2 and lymph node metastasis. Overall survival (OS) was estimated using the Kaplan-Meier method.ResultsThe study included 406 individuals with EC, 62.6% had type I and 37.4% had type II. Hypertension was seen in 132 (32.5%), hyperglycemia in 75 (18.5%), and overweight or obesity in 217 (53.4%). Hypertension, hyperglycemia, and obesity are strongly associated with the clinicopathologic features of EC. Multivariate logistic regression revealed that hyperglycemia (OR=2.439,95% CI: 1.025-5.804, P = 0.044) was a risk factor for myometrial invasion depth >1/2 in patients with type I EC, and hypertension (OR=32.124,95% CI: 3.287-313.992, P = 0.003) was a risk factor for lymph node metastasis in patients with type I EC. Survival analysis found that hyperglycemia (P < 0.001) and hypertension (P = 0.002) were associated with OS in type I EC. Neither hyperglycemia, hypertension, nor obesity were associated with the prognosis in type II EC.ConclusionHyperglycemia was a risk factor for myometrial invasion depth >1/2 in patients with type I EC and hypertension was a risk factor for lymph node metastasis in patients with type I EC. Hypertension and hyperglycemia were associated with poor prognosis in patients with type I EC.

Abstract Introduction Several studies have proved that Polygenic Risk Score (PRS) is a potential candidate for realizing precision screening. The effectiveness of low-dose computed tomography (LDCT) screening for lung cancer has been proved to reduce lung cancer specific and overall mortality, but the cost-effectiveness of diverse screening strategies remained unclear. Methods The comparative cost-effectiveness analysis used a Markov state-transition model to assess the potential effect and costs of the screening strategies incorporating PRS or not. A hypothetical cohort of 300,000 heavy smokers entered the study at age 50–74 years and were followed up until death or age 79 years. The model was run with a cycle length of 1 year. All the transition probabilities were validated and the performance value of PRS was extracted from published literature. A societal perspective was adopted and cost parameters were derived from databases of local medical insurance bureau. Sensitivity analyses and scenario analyses were conducted. Results The strategy incorporating PRS was estimated to obtain an ICER of CNY 156,691.93 to CNY 221,741.84 per QALY gained compared with non-screening with the initial start age range across 50–74 years. The strategy that screened using LDCT alone from 70–74 years annually could obtain an ICER of CNY 80,880.85 per QALY gained, which was the most cost-effective strategy. The introduction of PRS as an extra eligible criteria was associated with making strategies cost-saving but also lose the capability of gaining more LYs compared with LDCT screening alone. Conclusion The PRS-based conjunctive screening strategy for lung cancer screening in China was not cost-effective using the willingness-to-pay threshold of 1 time Gross Domestic Product (GDP) per capita, and the optimal screening strategy for lung cancer still remains to be LDCT screening for now. Further optimization of the screening modality can be useful to consider adoption of PRS and prospective evaluation remains a research priority.

Non-small cell lung cancer (NSCLC) accounted for the majority of lung cancer cases worldwide. Brain metastases (BM) frequently complicate NSCLC and portend a dismal prognosis. To control neurological symptoms, surgical resection is commonly followed by brain radiotherapy (RT). However, RT is often complicated by neurotoxicity. For patients with tumors that harbor positive driver genes, tyrosine kinase inhibitors are considered the standard of care. Nevertheless, treatment options for those without driver gene mutations are still debated. Programmed death receptor 1 (PD-1)/ligand 1 (PD-L1) inhibition has emerged as a novel therapeutic strategy for NSCLC patients with PD-L1-positive tumors, as well as for those with asymptomatic BM. However, the effect of anti-PD-1 antibodies on active BM within such specific populations is undetermined. Herein we present a case of a 65-year-old patient with NSCLC and high PD-L1-expressing BM. The patient underwent surgical resection of BM followed by first-line monotherapy with 31 cycles of zimberelimab, a novel anti-PD-1 antibody, and has already achieved 24 months of progression-free survival and intracranial recurrence-free survival. To our knowledge, this is the first report regarding the intracranial effect of zimberelimab on BM from primary lung cancer. This case report might facilitate an understanding of the intracranial effects of different anti-PD-1 antibodies for such populations.

Abstract Background Endometrial carcinoma (EC) is the second most common gynecological malignancy, and the differences between different pathological types are not entirely clear. Here, we retrospectively collected eligible EC patients to explore their differences regarding clinical characteristics and prognosis. Methods Five hundred seventy EC patients from the First Affiliated Hospital of Zhengzhou University were included. Prognostic factors were measured using the univariate/multivariate Cox models. Overall survival (OS) and progression-free survival (PFS) were the primary and secondary endpoints, respectively. Results In total, 396 patients with uterine endometrioid carcinoma (UEC), 106 patients with uterine serous carcinoma (USC), 34 patients with uterine mixed carcinoma (UMC), and 34 patients with uterine clear cell carcinoma (UCCC) were included. Comparison of baseline characteristics revealed patients diagnosed with UEC were younger, had more early clinical stage, and had lower incidence of menopause and lymph node metastasis. Compared to UEC, other pathological EC obtained more unfavorable OS (UCCC: HR = 12.944, 95%CI = 4.231–39.599, P

Objective To examine the prevalence and influencing factors of sleep duration among school-age children in Hainan province for improving sleep quality of the children. Methods Totally 25 162 children aged 6 – 12 years in 86 primary schools in Hainan province were recruited with stratified multistage random sampling. A self-designed questionnaire on demographics, sleep time and its associates was answered online by the children′s parents during November 2021 – January 2022. Logistic regression model was used to explore influencing factors of insufficient sleep in the children. ResultsFor the 24 200 children included in the final analysis, the parents-reported average weekday and weekend nighttime sleep time were 8.79 ± 0.81 and 9.51 ± 0.98 hours and the average total sleep time were 10.06 ± 1.18 and 11.62 ± 1.20 hours, respectively. Based on the parents′ reports, the prevalence of insufficient sleep (total sleep time < 10 hours/per day) was 30.8% and the prevalence linearly increased significantly with the increment of age among the children (P < 0.05). Logistic regression model analysis showed that the children with following characteristics were at significantly increased risk of having insufficient sleep time: aged 11 – 12 years (versus aged 6 – 7 years: odds ratio [OR] = 1.59, 95% confidence interval [95%CI]: 1.43 – 1.77); with paternal education of college and above (versus primary school: OR = 1.36, 95%CI: 1.15 – 1.60); from core families (versus from families of other types: OR = 1.13, 95%CI: 1.01 – 1.26) or from stem families (versus from families of other types: OR = 1.14, 95%CI: 1.04 – 1.36); having daily outdoor sports time of less than one hour (versus 2 hours and more: OR = 1.69, 95%CI: 1.42 – 2.00); and having daily screen exposure time of 2 hours and longer (versus that of less than one hour: OR = 1.34, 95%CI: 1.18 – 1.51). ConclusionInsufficient sleep time, especially insufficient nighttime sleep time, is prevalent among school-age children in Hainan province and at elder age, with higher paternal education, from core or stem families, less outdoor sports time, and longer screen exposure time are significant risk factors for insufficient sleep time in the school-age children.

Amorphophallus coaetaneus S. Y. Liu & S. J. Wei 1986 is a perennial herb belonging to the Araceae family in southwestern China (Guangxi and Yunnan provinces). Although this species have not been list in the red list of International Union for Conservation of Nature (IUCN), the populations are declining due to human over exploitation. To help to genetic diversity studies, we sequenced and assembled the complete chloroplast (cp) genome of A. coaetaneus (GenBank accession number of national center for biotechnology information (NCBI): OQ404947). The assembled genome revealed 175,465 bp in length with a GC content of 34.90%, including a large single-copy (LSC) region (98,561 bp), a small single-copy (SSC) region (16,504 bp) and two inverted repeat regions (IRs) (30,200 bp each). A total of 133 genes were annotated, of which 85 are protein-coding genes, 40 are tRNA genes and 8 are rRNA genes. As an output of this study, a maximum likelihood (ML) phylogenetic inference of 16 Araceae species clustered all four Amorphophallus species in one clade, and showed a relatively close relationship between the tribes Pythonieae and Colocasieae. The cp genome will serve as a basis in a more extensive molecular works covering all possible extant population of Amorphophallus, as well as conservation, breeding, and other ethnobotanical utilization of this species.

BackgroundStates are key actors in global health governance, particularly in the prevention and control of infectious diseases. The emergence and re-emergence of infectious diseases in recent decades pose profound challenges to global health security. As the first coronavirus pandemic, the COVID-19 caused significant damage worldwide, but responses and outcomes varied greatly among states. Using COVID-19 as an example, this study aims to compare the policies and measures implemented by different states during the COVID-19 pandemic and to synthesize experiences to strengthen global health governance for future infectious disease crises.MethodsWe used Arksey and O'Malley's five-stage scoping review framework and PRISMA methodology was used for literature search and decision on relevant studies. English databases were searched using combinations of keywords and articles examining COVID-19 prevention and control policies in representative countries were included. A comparative analysis across these four states (United States, Sweden, India, and Nigeria) was then conducted to analyse the differences, rationale, and challenges of the approaches taken by these states.ResultsA total of 36 studies were included in the analysis. The management of the COVID-19 by states is divided into two main categories: domestic governance and international governance. Domestically, the United States and India have taken more measures, yet notable disparities in infection source control, transmission interruption, vulnerable population protection, collaborative governance, and so on were observed among all four states. Globally, the United States and Sweden were more proactive in international governance, and all four states have variations in their adherence to global regulations, information sharing, resource distribution, and cooperative engagement.ConclusionsSignificant disparities occurred during the response to early COVID-19 in four states, which may be due to differences in politics, economy, and culture. To prevent and mitigate the impact of infectious diseases, states should, in future, prioritize solidarity and cooperation, and improve governance domestically and internationally based on national contexts and global health principles.

Cancer immunotherapy has been gradually introduced and has undergone noteworthy developments in recent years. The number of scientific publications has been expanding, and the progression in this field has been rapidly evolving with time. This study aimed to use bibliometric analysis to examine the past 20 years of research on cancer immunotherapy and identify future hotspots. A literature search for medical publications on immunotherapy in cancer from 2000 to 2021 was conducted in the Web of Science Core Collection on March 1, 2022. Visualization analysis was performed using VOSviewer software (version 1.6.16). From 2000 to 2021, a total of 18,778 publications were retrieved. Annual publication output grew rapidly from 366 in 2000 to 3,194 in 2021. The USA issued the largest number of publications (n = 6,739, 35.89%), with the University of Texas System making the largest contribution (n = 802, 4.27%). A total of 976 meaningful topics were identified and further classified into 4 different clusters (immune mechanism, cancer biology, immunotherapy and clinical trials). The most common research topics included ‘expression’, ‘chemotherapy’, ‘dendritic cells’, ‘pembrolizumab’ and ‘open-label’. Highly identified cancer types included hepatocellular, bladder, breast and lung cancer. A shift in popularity from mechanism research to clinical trials was observed, indicating that clinical application would be the center of attention in the future. Attention has been given to the field of cancer immunotherapy, and this trend will continue in the future. This study provides an unbiased visualization analysis on this topic in a scale-efficient manner for further research.

Rapid nondestructive testing of peanut seed vigor is of great significance in current research. Before seeds are sown, effective screening of high-quality seeds for planting is crucial to improve the quality of crop yield, and seed vitality is one of the important indicators to evaluate seed quality, which can represent the potential ability of seeds to germinate quickly and whole and grow into normal seedlings or plants. Meanwhile, the advantage of nondestructive testing technology is that the seeds themselves will not be damaged. In this study, hyperspectral technology and superoxide dismutase activity were used to detect peanut seed vigor. To investigate peanut seed vigor and predict superoxide dismutase activity, spectral characteristics of peanut seeds in the wavelength range of 400-1000 nm were analyzed. The spectral data are processed by a variety of hot spot algorithms. Spectral data were preprocessed with Savitzky-Golay (SG), multivariate scatter correction (MSC), and median filtering (MF), which can effectively to reduce the effects of baseline drift and tilt. CatBoost and Gradient Boosted Decision Tree were used for feature band extraction, the top five weights of the characteristic bands of peanut seed vigor classification are 425.48nm, 930.8nm, 965.32nm, 984.0nm, and 994.7nm. XGBoost, LightGBM, Support Vector Machine and Random Forest were used for modeling of seed vitality classification. XGBoost and partial least squares regression were used to establish superoxide dismutase activity value regression model. The results indicated that MF-CatBoost-LightGBM was the best model for peanut seed vigor classification, and the accuracy result was 90.83%. MSC-CatBoost-PLSR was the optimal regression model of superoxide dismutase activity value. The results show that the R2 was 0.9787 and the RMSE value was 0.0566. The results suggested that hyperspectral technology could correlate the external manifestation of effective peanut seed vigor.

Abstract Aims/Introduction The association between plasma irisin and glucose levels in the general population is controversial, and few studies have longitudinally detected this correlation. We aimed to examine whether irisin in pregnancy was associated with postpartum glucose levels among Chinese women and explore the modifiable factors. Materials and Methods We carried out a prospective cohort study in Guangzhou, China, during 2017 and 2018, and 453 pregnant women (20–28 weeks) were enrolled. Plasma irisin levels in pregnancy were tested. At 6–8 weeks after delivery, 93 women with gestational diabetes mellitus (GDM) underwent a 75‐g oral glucose tolerance test, and the other 360 women had a fasting blood glucose (FBG) test. Multivariable linear, quantile and logistic regressions were carried out. Results The mean plasma irisin in mid‐pregnancy was 13.73 ng/mL. We observed a significantly negative association between mid‐pregnancy irisin and postpartum FBG (β: −0.056 ± 0.024). However, quantile regression showed the association was only significant in high percentiles of FBG levels (P50 to P95), and the magnitude showed an increasing trend. Higher baseline irisin was also associated with a lower risk of postpartum impaired fasting glucose (relative risk 0.563, 95% confidence interval 0.384–0.825). Furthermore, we found significant interactions between irisin and predominant breast‐feeding on FBG and impaired fasting glucose (both Pinteraction

Abstract Background The objectives of this study were to screen out cut-off age value and age-related differentially expressed genes (DEGs) in clear cell renal cell carcinoma (CCRCC) from Surveillance Epidemiology and End Results (SEER) database and The Cancer Genome Atlas (TCGA) database. Methods We selected 45,974 CCRCC patients from SEER and 530 RNA-seq data from TCGA database. The age cut-off value was defined using the X-tile program. Propensity score matching (PSM) was used to balance the differences between young and old groups. Hazard ratio (HR) was applied to evaluate prognostic risk of age in different subgroups. Age-related DEGs were identified via RNA-seq data. Survival analysis was used to assess the relationship between DEGs and prognosis. Results In this study, we divided the patients into young (n = 14,276) and old (n = 31,698) subgroups according to cut-off value (age = 53). Age > 53 years was indicated as independent risk factor for overall survival (OS) and cancer specific survival (CSS) of CCRCC before and after PSM. The prognosis of old group was worse than that in young group. Eleven gene were differential expression between the younger and older groups in CCRCC. The expression levels of PLA2G2A and SIX2 were related to prognosis of the elderly. Conclusion Fifty-three years old was cut-off value in CCRCC. The prognosis of the elderly was worse than young people. It remind clinicians that more attention and better treatment should be given to CCRCC patients who are over 53 years old. PLA2G2A and SIX2 were age-related differential genes which might play an important role in the poor prognosis of elderly CCRCC patients.

Abstract Aims/Introduction The role of irisin in maternal glucose metabolism and how it would respond to dietary n‐3 polyunsaturated fatty acid (n‐3 PUFA) intake remains unclear. This study aimed to explore whether maternal plasma irisin is associated with glucose metabolism and whether this association is modified by dietary n‐3 PUFA. Materials and Methods A total of 932 pregnant women (20–28 weeks’ gestation) aged 20–45 years were recruited. Dietary n‐3 PUFA was estimated using a validated quantitative food frequency questionnaire. Plasma irisin and insulin were tested by enzyme‐linked immunosorbent assay, and insulin resistance (IR) was estimated using the homeostatic model assessment (HOMA). Gestational diabetes mellitus was diagnosed with a 75‐g oral glucose tolerance test. Adjusted multivariable linear regression and logistic regression were carried out to examine the associations between plasma irisin and glucose metabolism. The moderating effect of dietary n‐3 PUFA intake was determined by fully multiplicative models by including the interaction term. Results Maternal plasma irisin was negatively associated with HOMA‐IR and oral glucose tolerance test 0 h glucose level (β −0.250, −0.067; corrected P‐value for false discovery rate = 0.012, 0.018, respectively), positively associated with HOMA of insulin sensitivity (β 0.028; corrected P‐value for false discovery rate = 0.012), but not associated with postprandial glucose or the risk of gestational diabetes mellitus. Furthermore, we found a moderating effect of dietary n‐3 PUFA on the relationships of plasma irisin with HOMA‐IR and HOMA of insulin sensitivity; these associations were strengthened with increased n‐3 PUFA intake (β −0.037, 0.004; P = 0.014, 0.041, respectively). Conclusions Plasma irisin was negatively associated with HOMA‐IR and fasting glucose, whereas it was positively associated with HOMA of insulin sensitivity in pregnant women. We first showed that these associations were modified by dietary n‐3 PUFA intake.

Abstract Background Competitive endogenous RNAs (ceRNAs) have revealed a new mechanism of interaction between RNAs. However, an understanding of the ceRNA regulatory network in Wilms tumour (WT) remains limited. Methods The expression profiles of mRNAs, miRNAs and lncRNAs in Wilms tumour samples and normal samples were obtained from the Therapeutically Applicable Research to Generate Effective Treatment (TARGET) database. The EdgeR package was employed to identify differentially expressed lncRNAs, miRNAs and mRNAs. Functional enrichment analyses via the ClusterProfile R package were performed, and the lncRNA–miRNA–mRNA interaction ceRNA network was established in Cytoscape. Subsequently, the correlation between the ceRNA network and overall survival was analysed. Results A total of 2037 lncRNAs, 154 miRNAs and 3609 mRNAs were identified as differentially expressed RNAs in Wilms tumour. Of those, 205 lncRNAs, 26 miRNAs and 143 mRNAs were included in the ceRNA regulatory network. The results of Gene Ontology (GO) analysis revealed that the differentially expressed genes (DEGs) were mainly enriched in terms related to response to mechanical stimuli, transcription factor complexes, and transcription factor activity (related to RNA polymerase II proximal promoter sequence-specific DNA binding). The results of the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis showed that the DEGs were mainly enriched in pathways related to the cell cycle. The survival analysis results showed that 16 out of the 205 lncRNAs, 1 out of 26 miRNAs and 5 out of 143 mRNAs were associated with overall survival in Wilms tumour patients (P

Background: Early comprehensive treatment models (CTMs) have been developed as effective treatments for children with autism spectrum disorder (ASD). Numerous studies have suggested that CTMs can improve short-term outcomes, but little is known about precise outcome information in childhood. The current meta-analysis reviewed studies reporting broader outcomes in children with ASD who had ever participated in a CTM and examined the predictors of developmental gains.Methods: We searched eight databases up to June 13, 2019, for relevant trials and natural experiments. Longitudinal studies were selected if they investigated the outcomes of CTMs. Two meta-analyses were undertaken to provide a summary estimate of change in treatment outcomes and to evaluate the effect of CTMs; one used the standardized mean change between the pretest and posttest, and the other was a classical meta-analysis. Stratified and random-effects meta-regression analyses were performed to search for outcome differences among studies.Results: Eighteen intervention studies (involving 495 children with ASD) met all the inclusion criteria: 12 used early intensive behavioral intervention (EIBI), and two used the Early Start Denver Model (ESDM). Outcomes were categorized into three parts: cognitive, language and behavioral (e.g., adaptive functioning and symptomatology). Overall, most children with ASD who had ever participated in an early CTM made gains in many areas of functioning, especially in terms of symptom- and language-related outcomes. Stratified analyses indicated that the ESDM displayed the largest effect on IQ improvement (ES = 1.37, 95% CI: 0.95 to 1.80), while EIBI was more effective for symptom reduction (ES = −1.27, 95% CI: −1.96 to −0.58). Further, meta-regression suggested that interventions with parent involvement, higher intensity, and longer treatment hours yielded greater improvements in IQ and social adaptive functioning, respectively.Conclusion: The results demonstrate a positive association between CTMs and better prognosis in childhood, especially regarding symptoms, and language. However, most extant research involves small, non-randomized studies, preventing definitive conclusions from being drawn. Clearly, the outcomes of children with ASD are still far from normal, especially with respect to adaptive functioning, and the four mediating variables pertaining to treatment elements can affect their gains, including approach, implementer, intensity, and total treatment hours.Systematic Review Registration: [www.crd.york.ac.uk/PROSPERO], identifier [CRD42019146859].

Background: Previous studies have suggested that maternal dietary protein was associated with allergic diseases in offspring, but few studies have evaluated the influence of dietary protein patterns. This study aimed to explore the prospective association between maternal dietary protein patterns during pregnancy and the risk of infant eczema.Methods: A total of 713 mother-child pairs from a prospective cohort in Guangzhou, China were recruited. Maternal dietary protein was estimated using a validated face-to-face food frequency questionnaire at 20–28 weeks' gestation from 2017 to 2018. Dietary protein patterns were calculated based on the sources of protein. The data of infant eczema was assessed at 6 months of age using the symptom questionnaire of eczema. Logistic regression was carried out to examine the associations between maternal dietary protein patterns and infant eczema.Results: The cumulative incidence of infant eczema at 6 months of age was 51.19%. Mothers of infants with eczema consumed more protein from poultry source during pregnancy than mothers of infants without eczema, while no statistical differences were observed in maternal intakes of protein from cereals and tubers, vegetables, fruits, red meat, fish and seafood, eggs, dairy, soybean, and nuts and seeds. Four dietary protein patterns were identified and termed poultry, plant, dairy and eggs, and red meat and fish. The cumulative incidence of eczema was 61.2, 45.8, 48.0, 51.4% for these four patterns, respectively. Compared to the poultry dietary pattern, the plant pattern and the dairy and eggs pattern were associated with a reduced risk of infant eczema, and the adjusted odds ratios (95% confidence interval) were 0.572 (0.330–0.992), 0.478 (0.274–0.837), respectively. No such association was observed for the red meat and fish dietary protein pattern.Conclusion: This is the first study that focused on the association between maternal dietary protein during pregnancy from a whole-diet perspective and infant eczema. Compared with the poultry dietary protein pattern, the maternal plant pattern and the dairy and eggs pattern during pregnancy were associated with a reduced risk of infant eczema.

Aims: Within the past few years, there has been tremendous growth in clinical trials of chimeric antigen receptor (CAR) T-cell therapies. Unlike those of many small-molecule pharmaceuticals, CAR T-cell therapy clinical trials are fraught with risks due to the use of live cell products. The aim of this study is to reach a consensus with experts on the most relevant set of risks that practically occur in CAR T-cell therapy clinical trials. Methods: A Delphi method of consensus development was used to identify the risks in CAR T-cell therapy clinical trials, comprising three survey rounds. The expert panel consisted of principal investigators, clinical research physicians, members of institutional ethics committees, and Good Clinical Practice managers. Results: Of the 24 experts invited to participate in this Delphi study, 20 participants completed Round 1, Round 2, and Round 3. Finally, consensus (defined as >80% agreement) was achieved for 54 risks relating to CAR T-cell clinical trials. Effective interventions related to these risks are needed to ensure the proper protection of subject health and safety. Conclusion: The Delphi method was successful in gaining a consensus on risks relevant to CAR T-cell clinical trials in a geographically diverse expert association. It is hoped that this work can benefit future risk-based quality management in clinical trials and can potentially promote the better development of CAR T-cell therapy products.

Errors are natural elements of the learning process and provide a high potential to promote students' learning outcomes. In recent years, there has been much research about learning from errors. However, we know little about the relationship between students' error beliefs in chemistry and chemistry learning outcomes at present. Thus, the aim of this study was to explore the mechanisms of chemistry behavioral and cognitive engagements, adaptive reactions towards errors in chemistry and error beliefs in chemistry, and offer suggestions to the improvement of students' chemistry learning outcomes. We assessed all variables in eight different schools in China (N = 1352 students, Grade 10) and used structural equation modelling (SEM) to check the direct and indirect relationships between four variables. Our findings revealed that (1) chemistry behavioral and cognitive engagements, adaptive reactions towards errors in chemistry and error beliefs in chemistry significantly positively predicted students' chemistry learning outcomes; (2) both (a) adaptive reactions towards errors in chemistry and (b) chemistry behavioral and cognitive engagements acted as significant mediators between error beliefs in chemistry and chemistry learning outcomes; (3) the chain mediating effect of error beliefs in chemistry [right arrow] adaptive reactions towards errors in chemistry [right arrow] chemistry behavioral and cognitive engagements [right arrow] chemistry learning outcomes was significant. Finally, we discussed the important findings, pointed out the educational implications, acknowledged our study's limitations and suggested directions for future study.