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Abstract Background It is known that open wedge high tibial osteotomy (OWHTO) may lead to progression of patellofemoral degeneration due to descent of the patellar height. However, the difference in patellofemoral joint (PFJ) loads with normal daily activity between uniplane and biplane osteotomies is unclear. The purpose of this study was to reveal the differences in PFJ biomechanics between uniplane and biplane OWHTO using finite element analysis (FEA). Methods In this study, a finite element model of the knee joint was established using computed tomography (CT) and magnetic resonance imaging (MRI) data from a healthy volunteer, and a 10° varus deformity of the proximal tibia was simulated. Under the guidance of experienced orthopedic surgeons, simulations of both uniplane and biplane open wedge high tibial osteotomy procedures were conducted. The maximum stress and contact area of the PFJ at knee flexion angles of 90°, 60°, 30°, and 0° during sitting-to-standing and walking were measured in the three finite element models (normal knee joint model, uniplane OWHTO model, and biplane OWHTO model). Results In all models, the peak value of von-mises stress (VMS) occurred at 90 degrees of knee flexion. At 90 degrees of knee flexion, the biplane OWHTO model exhibited the highest PFJ stress, measuring 9.664 MPa. As the knee joint extended from 90 degrees of flexion to 0 degrees of extension, the PFJ stress gradually decreased in all three models. The decrease was most pronounced in the uniplane OWHTO model, although it remained higher than in the normal model. Conclusion Uniplane OWHTO would induce lower contact stress and larger contact area on the patellofemoral surface than biplane OWHTO during walking and sitting-to-standing, which may cause less mechanical pain and secondary damage to the articular cartilage. Therefore, uniplane OWHTO might be a better option for patients with anterior knee pain and/or PFJ degeneration.

Abstract Background Neuroblastoma (NB), the most prevalent solid tumor in children, arises from sympathetic nervous system and accounts for 15% of pediatric cancer mortality. This malignancy exhibits substantial genetic and clinical heterogeneity, thus complicating treatment strategies. Poly(ADP-ribose) polymerase 1 (PARP1), a key enzyme catalyzing polyADP-ribosylation (PARylation), plays critical roles in various cellular processes, and contributes to tumorigenesis and aggressiveness. However, the functions and regulatory mechanisms of PARP1 in NB progression still remain to be determined. Methods The association of PARP1 expression with NB patients’ survival was analyzed by mining of R2 database. Western blotting, reverse transcription-polymerase chain reaction, MTT colorimetric, soft agar, and matrigel invasion assays were utilized to assess PARP1 expression and its effects on aggressiveness of NB cell lines. Chromatin immunoprecipitation (ChIP) sequencing and ChIP assays were employed to investigate the binding of Yin Yang 1 (YY1) to PARP1 promoter. Protein interactions were explored by BioGRID database analysis, molecular docking, and co-immunoprecipitation assay. RNA sequencing and crosslinking-immunoprecipitation high throughput sequencing datasets were used to identify precursor mRNA splicing targets of non-POU domain containing octamer binding protein (NONO). Results High PARP1 expression was associated with poor survival of NB patients. PARP1 over-expression enhanced the proliferation and invasion of NB cell lines, confirming its oncogenic roles. YY1 was identified as a key transcriptional regulator facilitating PARP1 expression. Additionally, PARP1 interacted with NONO to induce its PARylation, resulting in stabilization of NONO protein via preventing ubiquitin-mediated degradation. NONO facilitated the splicing and mRNA maturation of target genes a disintegrin and metalloproteinase domain 8 (ADAM8) and testis-expressed gene 14 (TEX14) in a PARylation-dependent manner. Rescue experiments indicated that YY1 facilitated PARP1-mediated PARylation of NONO and subsequent mRNA maturation of ADAM8 and TEX14 in NB cells. In clinical NB cases, high expression of YY1, PARP1, NONO, ADAM8, or TEX14 was associated with poor survival of patients. Conclusions These findings indicate that YY1 drives PARP1 expression essential for PARylation of NONO in mRNA maturation during NB progression.

Abstract A randomized double-blind phase 3 trial (CHOICE-01, NCT03856411) demonstrated that combining toripalimab with chemotherapy substantially improves progression-free survival (PFS) in advanced non-small cell lung cancer (NSCLC) patients without pretreatment. This study presents the prespecified final analysis of overall survival (OS) and biomarkers utilizing circulating tumor DNA (ctDNA) and tissue-based sequencing. Additionally, the analysis revealed a higher median overall survival (OS, 23.8 months) in the toripalimab group than that in the control group (17.0 months). (HR = 0.69, 95%CI: 0.57–0.93, nominal P = 0.01). This survival benefit was particularly notable in the non-squamous subgroup. As the first phase 3 study to perform both baseline tissue whole-exome sequencing (WES) and peripheral blood ctDNA testing, we investigated efficacy predictive biomarkers based on both tissue and ctDNA, Genomic sequencing of ctDNA showed high concordance with tumor tissue independently confirmed that individuals exhibiting a high tumor mutational burden, as well as mutations in the FA-PI3K-Akt and IL-7 signaling pathways benefited more from the toripalimab treatment. Furthermore, a ctDNA response observed on cycle 3 day 1, was associated with improved clinical outcomes for patients treated with the combination therapy. In conclusion, Toripalimab plus chemotherapy yields significant improvements in OS as a first-line treatment. The study highlights the utility of ctDNA as a proxy for tumor tissue, providing novel prospects for predicting efficacy of immuno-chemotherapy through continuous ctDNA monitoring.

Abstract Current traffic status detection methods heavily rely on historical traffic flow data and vehicle counts. However, these methods often fail to meet the stringent real‐time requirements of state detection, especially on edge devices with limited computing resources.To address these challenges, this study develops a traffic alert model using temporal video frame analysis and grayscale aggregation quantization techniques. Initially, the model uses distance mapping between pixel features and frames of road traffic videos to construct a comprehensive road environment and vehicle segmentation model. The model also establishes a mapping between pixel equidistant lines and actual distances, enabling precise congestion detection. This approach significantly reduces costs associated with traditional traffic detection methods as it does not rely on historical data. Performance evaluation using fixed‐point road monitoring data indicates that the proposed model outperforms traditional traffic state detection models, with a performance improvement of approximately 4.7% to 9.5%. Additionally, the model improves computing resource efficiency by approximately 72.5% and demonstrates substantial real‐time detection capabilities.

Landfills are typical point, line, and area odor pollution sources, characterized by the complex components, variable properties, and the difficulty of control. Accurate processing based on component characteristics is crucial for achieving effective control. This paper sorts out the release characteristics of typical waste components (e.g., kitchen waste, sludge, waste plastics, etc.) during stabilization in different states. The study explores the interaction between different waste components and the influences of complex volatile organic compounds (VOCs) release. To understand the source and formation mechanism of landfill odor, research is needed on the relationship between odor gas and the landfill′s multi-component waste characteristics, different landfill time, and varying environmental conditions. To address the variability of landfill odor, the study utilizes artificial neural networks (ANN) coupled with electronic nose, employing the forward propagation formula hl=σ(Wlhl−1+bl) in multilayer perceptrons (MLP) to enhance the model′s ability to accurately respond to odor changes. Real-time monitoring and feedback enable effective odor control through source component classification control, process chemical targeting, and end-of-pipe biological treatment.

The fibroblast growth factor receptor (FGFR) is a crucial receptor tyrosine kinase involved in essential biological processes, including growth, development, and tissue repair. However, FGFR gene mutations, including amplification, fusion, and mutation, can disrupt epigenetics, transcriptional regulation, and tumor microenvironment interactions, leading to cancer development. Targeting these kinase mutations with small molecule drugs or antibodies has shown clinical benefits. For example, erdafitinib is approved for treating locally advanced or metastatic urothelial cancer patients with FGFR2/FGFR3 mutations, and pemigatinib is approved for treating cholangiocarcinoma with FGFR2 fusion/rearrangement. Effective screening of FGFR variant patients is crucial for the clinical application of FGFR inhibitors. Various detection methods, such as polymerase chain reaction, next-generation sequencing, fluorescence in situ hybridization, and immunohistochemistry, are available, and their selection should be based on diagnostic and treatment decision-making needs. Our developed expert consensus aims to standardize the diagnosis and treatment process for FGFR gene mutations and facilitate the practical application of FGFR inhibitors in clinical practice.

Abstract Background A blood-based diagnostic test is a promising strategy for colorectal cancer (CRC). The MethyDT test (IColohunter), which detects methylation levels of NTMT1 and MAP3K14 -AS1, exhibited potential in discriminating CRC, but its clinical performance needs to be validated in large-scale populations. Methods A multicenter, double-blinded, cross-sectional study that enrolled 1194 participants was performed. Plasma samples were collected to detect methylation levels of NTMT1 and MAP3K14 -AS1 using quantitative methylation-specific PCR with the MethyDT test, and the accuracy was further evaluated by Sanger sequencing. Results The sensitivities of the MethyDT test for detecting CRC, early stages of CRC (I and II), advanced adenoma (AA), and high-grade intraepithelial neoplasia (HGIN) were 91.2% (95% confidence interval [CI], 88.4–94.0), 87.4% (95% CI, 82.5–92.2), 43.5% (95% CI, 35.7–51.4), and 72.7% (95% CI, 57.5–87.9), respectively. The specificities for participants with non-AA, interfering diseases (ID), and no evidence of disease (NED) were 85.0% (95% CI, 78.8–91.3), 93.7% (95% CI, 91.4–95.9) and 97.3% (95% CI, 90.5–99.7), respectively, and its overall specificity for all-controls was 92.4% (95% CI, 90.3–94.4). The consistency of the MethyDT test with pathology for CRC was high with a kappa value of 0.830 (95% CI, 0.795–0.865). Additionally, the MethyDT test was comparable to Sanger sequencing for detecting methylation with kappa values > 0.97. Conclusions The MethyDT test demonstrates excellent sensitivity and specificity for CRC and high consistency with Sanger sequencing for methylation, suggesting it may serve as a potential noninvasive diagnostic tool for the detection of CRC. Trial registration This clinical trial has been registered in ClinicalTrials.gov (NCT05508503).

To further investigate the role of vibration isolation structure in torpedo noise control, in this paper, a dynamic characteristic identification bench of vibration isolation materials based on a beam model was established, and the elastic modulus and damping of poly-ether-ether-ketone materials were identified and verified. The finite element model of bolt vibration isolation structure was established, and the accuracy of the model was verified. The model was applied to the connection between the torpedo engine and the shell. Combined with the vibration isolation ring modeling theory and bolt vibration isolation structure, a torpedo-powered vibration isolation simulation model was established for the first time. The simulation results show that the vibration noise of torpedoes can be reduced by 3.64 dB by comprehensively using vibration isolation rings combined with bolt connections. The results provide strong theoretical support for torpedo vibration noise control.

Objective: To quantify retinal morphological characteristics in patients with myopic traction maculopathy (MTM), including myopic foveoschisis (MF), using optical coherence tomography angiography (OCTA) and investigate the correlation of MTM with visual function. Methods: This cross-sectional study included 19 eyes with myopic foveoschisis (MF) and foveal detachment (FD), 37 eyes with MF without FD, and 24 myopic eyes as control. OCTA was used to assess macular vessel density (VD) in the superficial capillary plexus (SCP), deep capillary plexus (DCP), foveal avascular zone (FAZ) area, FAZ perimeter, acircularity index, retinal thickness, and retinal volume. Microperimetry was performed to evaluate macular sensitivity (MS) covering the central 20°, 10°, 2° field centered at fovea. Correlations between macular microcirculation parameters, best-corrected visual acuity (BCVA), and MS were determined. Results: Compared to myopic controls, decreased macular parafoveal SCP VD, DCP VD, and the area VD in a 300 µm wide annulus surrounding the FAZ (FD-300), were found in the group of MF patients with FD, with (p = 0.007, 0.002, 0.005) respectively, and in the group of MF patients without FD, with (p = 0.01, 0.049, 0.009), respectively. In the MF without FD group, parafoveal SCP VD significantly correlated with BCVA, 2°MS, 10°MS, and 20°MS (p = 0.018, 0.002, 0.001, 0.029), FD-300 area density, retinal thickness, and retinal volume was significantly correlated with BCVA (p = 0.024, 0.015, 0.045). In the MF with FD group, DCP VD was significantly associated with 10° and 20° MS (p = 0.048, 0.014), as were retinal thickness and volume (all p < 0.05); however, FD-300 area density correlated significantly with BCVA (p = 0.014). Conclusions: Macular perfusion is closely associated with functional alterations in MTM. Macular VD could serve as a valuable biomarker for monitoring MTM progression and optimizing medical and surgical decisions.

Objective: Advanced lesions are often ignored in well-differentiated colorectal neuroendocrine neoplasms (NENs) smaller than 2 cm, and we aimed to develop an effective nomogram for these lesions. Methods: We extracted data from the Surveillance, Epidemiology, and End Results (SEER) database and used a logistic regression model to identify independent risk factors for advanced disease. All these identified factors were included to construct the prediction model, and the receiver operating characteristic (ROC) curve, calibration plot and DCA curve were utilized to assess the predictive value. The data obtained from the National Cancer Center were utilized for external validation. Results: In total, 3223 patients were enrolled in the training set, including 2947 (91.4 %) with early disease and 276 (8.6 %) with advanced disease. The logistic analysis showed that age (odds ratio (OR) = 1.486, 95 % confidence interval (CI): 1.102–2.003, P = 0.009), tumor size (OR = 11.071, 95 % CI: 8.229–14.893, P

The existing non-unit traveling wave (TW) protection schemes of flexible direct current (DC) transmission lines based on time domain analysis cannot withstand high transition resistance. Thus, this study analyzes the TW propagation characteristics of flexible DC lines and obtains the characteristic differences in line-mode voltage reverse TW derivatives in the case of internal and external faults. The Levenberg–Marquardt method is used to fit the fault TW; the differences in the waveform features of the reverse TW rate-of-change under internal and external faults are extracted, and the characteristic quantities for internal and external fault identification are constructed by using fitting residuals and dominant term exponents in the fitting results. Finally, a simulation model for flexible DC transmission systems is established via PSCAD, and the effectiveness of the proposed scheme is verified. The results show that this method uses overall waveform characteristics to realize fault detection, is less affected by transition resistance, can withstand up to 800 Ω in transition resistance. Moreover, the influence of TW refraction and reflection on the fitting results is mitigated by means of fitting residuals, allowing for the reliable identification of faults across the entire line.

To address the problems of poor speed performance and the large influence of the distributed capacitance of traditional pilot differential protection, a pilot protection scheme based on the characteristics of the transient voltage waveform is proposed. First, the expression of the relationship between the fault voltage of the current-limiting reactor and the measuring point is derived. From the theoretical derivation, it can be inferred that for internal faults, the voltage ratio of the current-limiting reactor to the measuring point on both sides of the HVDC line is constant over a short period. For external faults, the voltage ratio of the current-limiting reactor to the measuring point varies exponentially on the fault side, while on the other side, it remains constant. Based on the above characteristics, the waveform characteristics of the voltage ratio of the current-limiting reactor to the measuring point are used to establish a protection criterion. A pilot protection scheme based on the standard deviation coefficient is proposed. The simulation results show that this method can reliably identify internal and external faults and has high sensitivity and selectivity. Moreover, this method is reliable for different types of faults and fault resistances. In addition, the proposed protection scheme can identify the type of fault in a short time window, requires a low sampling frequency, and does not require data synchronization.

IntroductionThe causality between personality and psychiatric traits and lung cancer (LC) remains unclear. Therefore, we aimed to elucidate the causality between these traits and LC.MethodsBidirectional two-sample Mendelian randomization (MR) and bibliometric approaches were conducted to estimate the causality between personality (neuroticism, extraversion, agreeableness, conscientiousness, and openness) and psychiatric (schizophrenia, attention-deficit/hyperactivity disorder [ADHD], major depressive disorder, autism spectrum disorder, bipolar disorder, insomnia, and anxiety) traits and LC and its subtypes (lung squamous cell carcinoma, lung adenocarcinoma, and small cell LC). Summary data of these traits were extracted from large datasets (17,375–462,341 participants). Inverse variance weighting was used as the primary MR analysis, with supplementary models, including MR-Egger and weighted medians. Sensitivity analyses were conducted to detect pleiotropy. Bibliometric data were retrieved from the Web of Science Core Collection, Scopus, and PubMed. The main mapping techniques adopted were co-word, collaboration, and citation analyses.ResultsSchizophrenia was associated with an increased risk of LC (odds ratio [OR] = 1.077, 95% confidence interval [CI] = 1.030–1.126, P = 0.001). Moreover, LC increased the risk of ADHD (OR = 1.221, 95% CI = 1.096–1.362, P < 0.001). No significant bidirectional associations were observed between other mental traits and LC and its subtypes. Causality, psychiatry, and psychiatric comorbidity are emerging keywords. Research dynamics and landscapes were revealed.ConclusionThis study suggests that schizophrenia is a risk factor for LC and that LC is a risk factor for ADHD. Furthermore, causality, psychiatry, and psychiatric comorbidity have become emerging research trends in related fields.

BackgroundThe disruption of circadian rhythm has been reported to aggravate the progression of diabetic retinopathy (DR). Rest-activity rhythm (RAR) is a widely used method for measuring individual circadian time influencing behavior. In this study, we sought to explore the potential association between RAR and the risk of DR.MethodsDiabetic participants aged over 40 from 2011-2014 National Health and Nutrition Examination Survey (NHANES) were enrolled. Data from the wearable device ActiGraph GT3X was used to generate RAR metrics, including interdaily stability (IS), intradaily variability (IV), most active 10-hour period (M10), least active 5-hour period (L5), and Relative amplitude (RA). Weighted multivariable logistic regression analysis and restricted cubic spline analysis were conducted to examine the association between RAR metrics and DR risk. Sensitivity analysis was also conducted to examine the robustness of the findings. An unsupervised K-means clustering analysis was conducted to identify patterns in IV and M10.ResultsA total of 1,096 diabetic participants were enrolled, with a DR prevalence of 20.53%. The mean age of participants was 62.3 years, with 49.57% being male. After adjusting covariates, IV was positively associated with DR (β: 3.527, 95%CI: 1.371-9.073). Compared with the lowest quintile of IV, the highest quintile of IV had 136% higher odds of DR. In contrast, M10 was negatively associated with DR (β: 0.902, 95%CI: 0.828-0.982), with participants in the highest M10 quintile showing 48.8% lower odds of DR. Restricted cubic spline analysis confirmed that these associations were linear. Meanwhile, sensitivity analysis confirmed the robustness. K-means clustering identified three distinct clusters, with participants in Cluster C (high-IV, low-M10) had a significantly higher risk of DR comparing with Cluster A (low-IV, high-M10).ConclusionA more fragmented rhythm and lower peak activity level might be associated with an increased risk of DR. These findings indicate that maintaining a more rhythmic sleep-activity behavior might mitigate the development of DR. Further research is necessary to establish causality and understand the underlying mechanisms, and focus on whether interventions designed to enhance daily rhythm stability and increase diurnal activity level can effectively mitigate the risk of progression of DR.

Abstract Radiated tumor cell‐derived extracellular vesicles (RT‐EVs) encapsulate abundant DNA fragments from irradiated tumor cells, in addition to acting as integrators of multiple tumor antigens. Accumulating evidence indicates these DNA fragments from damaged cells are involved in downstream immune responses, but most of them are degraded in cells before incorporation into derived RT‐EVs, thus the low abundance of DNA fragments limits immune responses of RT‐EVs. Here, this study found that different radiations affected fates of DNA fragments in RT‐EVs. Boron neutron capture therapy (BNCT) induced DNA accumulation in RT‐EVs (BEVs) by causing more DNA breaks and DNA oxidation resisting nuclease degradation. This is attributed to the high‐linear energy transfer (LET) properties of alpha particles from the neutron capture reaction of 10B. When being internalized by dendritic cells (DCs), BEVs activated the DNA sensing pathway, resulting in functional enhancements including antigen presentation, migration capacity, and cytokine secretion. After vaccination of the BEVs‐educated DCs (BEV@BMDCs), the effector T cells significantly expanded and infiltrated into tumors, suggesting robust anti‐tumor immune activation. BEV@BMDCs not only effectively inhibited the primary tumor growth and metastasis formation but also elicited long‐term immune memory. In conclusion, a successful DC vaccine is provided as a promising candidate for tumor vaccine.

Abstract Background The aim of the present study was to compare the predictive accuracy of PD‐L1 immunohistochemistry (IHC), tissue or blood tumor mutation burden (tTMB, bTMB), gene expression profile (GEP), driver gene mutation, and combined biomarkers for immunotherapy response of advanced non‐small cell lung cancer (NSCLC). Methods In part 1, clinical trials involved with predictive biomarker exploration for immunotherapy in advanced NSCLC were included. The area under the curve (AUC) of the summary receiver operating characteristic (SROC), sensitivity, specificity, likelihood ratio and predictive value of the biomarkers were evaluated. In part 2, public datasets of immune checkpoint inhibitor (ICI)‐treated NSCLC involved with biomarkers were curated (N = 871). Odds ratio (OR) of the positive versus negative biomarker group for objective response rate (ORR) was measured. Results In part 1, the AUC of combined biomarkers (0.75) was higher than PD‐L1 (0.64), tTMB (0.64), bTMB (0.68), GEP (0.67), and driver gene mutation (0.51). Combined biomarkers also had higher specificity, positive likelihood ratio and positive predictive value than single biomarkers. In part 2, the OR of combined biomarkers of PD‐L1 plus TMB (PD‐L1 cutoff 1%, 0.14; cutoff 50% 0.13) was lower than that of PD‐L1 (cutoff 1%, 0.33; cutoff 50% 0.24), tTMB (0.28), bTMB (0.48), EGFR mutation (0.17) and KRAS mutation (0.47), for distinguishing ORR of patients after immunotherapy. Furthermore, positive PD‐L1, tTMB‐high, wild‐type EGFR, and positive PD‐L1 plus TMB were associated with prolonged progression‐free survival (PFS). Conclusion Combined biomarkers have superior predictive accuracy than single biomarkers for immunotherapy response of NSCLC. Further investigation is warranted to select optimal biomarkers for various clinical settings.

Abstract Background Pneumonic-type lung adenocarcinoma (P-ADC) is a rare and challenging subtype of primary lung cancer that can be difficult to distinguish from pneumonia based on radiological images. Furthermore, no drugs are currently available that specifically target KRAS G12V. Case presentation Here we report a case of P-ADC with typical and informative imaging features throughout the course of the disease, including patchy shadows, high-density lesions with aerated bronchus, diffuse ground-glass opacities, and nodular shadows from computed tomography (CT) scan. The KRAS G12V mutation was detected using Next-generation sequencing (NGS). An individualized Afatinib-based therapeutic schedule was prescribed and achieved sustained response after multiple lines of treatment had failed. Conclusion Our case highlights the typical and dynamic changes in imaging features of P-ADC and provides an indicative treatment strategy for KRAS G12V-mutated lung adenocarcinoma.

Abstract Background The efficacy of palliative primary tumor resection (PTR) in improving prognosis for patients with unresectable metastatic colorectal neuroendocrine neoplasms (NENs) has not been fully explored. Methods We performed one retrospective cohort study and recruited 68 patients with unresectable metastatic colorectal NENs from two Chinese medical centers between 2000 and 2022. All patients were assigned to PTR group and no PTR group. The clinicopathological manifestation data were carefully collected, and the survival outcomes were compared between the two groups using Kaplan–Meier methods. Propensity score matching (PSM) was conducted to minimize confounding bias. Univariate and multivariate Cox proportional hazards regression analyses were performed to identify prognostic factors. Results A total of 32 patients received PTR, and the other 36 patients did not. The median progression-free survival (PFS) and overall survival (OS) times were 4 and 22 months in the whole cohort, respectively. For patients who received no PTR, the median OS was 16 months, and the 1-year OS rate and 3-year OS rate were 56.4% and 39.6%, respectively. For patients who received PTR, the median OS was 24 months, and the 1-year OS rate and 3-year OS rate were 67.9% and 34.1%, respectively. However, the Kaplan–Meier survival curves and log-rank test demonstrated no significant survival difference between the two groups (P = 0.963). Moreover, palliative PTR was also not confirmed as a prognostic factor in subsequent univariable and multivariable Cox proportional hazards regression analyses in both the original and matched cohorts. Only histological differentiation was identified as an independent prognostic factor affecting PFS [hazard ratio (HR) = 1.86, 95% confidence interval (CI): 1.02–3.41, P = 0.043] and OS [HR = 3.70, 95% CI: 1.09–12.48, P = 0.035] in the original cohort. Conclusions Palliative PTR may not offer survival benefits for patients with unresectable metastatic colorectal NENs.

Background: Tumor necrosis (TN) is a common feature in lung squamous cell carcinoma (LSCC), which could provide useful predictive and prognostic information. Objectives: This study aimed to investigate the effect of pretreatment pulmonary TN (PTN) on the prognosis of first-line anti-programmed cell death 1 (PD-1)/PD ligand 1 (PD-L1) inhibitor in advanced LSCC. Design: We conducted a retrospective study to analyze the association between the presence of PTN and clinical outcomes in advanced LSCC patients treated with anti-PD-1/PD-L1 inhibitors. Methods: Data from 240 eligible patients were collected from 27 hospitals across China between 2016 and 2020. The presence of PTN was assessed using contrast-enhanced chest computed tomography (CT) imaging at baseline. We utilized the Cox proportional-hazards regression model to analyze the association between PTN and clinical outcomes. In addition, to account for potential confounding factors and ensure comparability between groups, we employed propensity score-matching (PSM) analysis. Results: In the overall patient cohort, the presence of PTN was 39.6%. The median follow-up duration was 20.3 months. The positive PTN group exhibited a notably inferior median progression-free survival (PFS; 6.5 months vs 8.6 months, p = 0.012) compared to the negative PTN group. Within the Cox proportional-hazards regression model, PTN emerged as an independent predictor of unfavorable PFS (hazard ratio (HR) = 1.354, 95% confidence interval (CI): 1.002–1.830, p = 0.049). After PSM, the median PFS for the positive PTN group (6.5 months vs 8.0 months, p = 0.027) remained worse than that of the negative PTN group. Multivariate analyses also further underscored that the presence of PTN independently posed a risk for shorter PFS (HR = 1.494, 95% CI: 1.056–2.112, p = 0.023). However, no statistically significant difference in overall survival was observed between the two groups. Conclusion: Our study suggests that the presence of PTN on baseline contrast-enhanced chest CT is a potential negative prognostic imaging biomarker for the outcome of anti-PD-1/PD-L1 inhibitor therapy in advanced LSCC. Further studies are warranted to validate these findings and explore the underlying mechanisms.

Changes in land-use patterns are the main driving factors of ecosystem service values (ESVs). The quantitative evaluation of ESVs is significant for the sustainable development of ecologically fragile areas. In this study, the Chishui River Basin (CRB) in China was selected as the study region, and an intensity map (IM) was used to analyze the transformation of land use/land cover (LULC). The modified equivalent coefficient value method was used to evaluate the ESVs based on the 2000, 2010, and 2020 land use datasets. The spatial and temporal distributions of ESV and its response to changes in LULC were analyzed using the Getis-Ord Gi* statistical method and Spearman’s rank correlation analysis. Moreover, spatial and temporal changes in LULC and ESV over the next 30 years in the four development scenarios were simulated using the Markov-PLUS model. The following results were obtained: 1) The farmland and forestland were the dominant LULC categories, and that the LULC pattern dramatically changed in the study area; 2) the total ESV of the CRB decreased significantly from 23.21 billion yuan in 2000 to 22.29 billion yuan in 2020; and 3) the ecological conservation scenario significantly promoted the total ESV, and the town development scenario was more conducive to the urbanization process. Therefore, although the ESV of the CRB showed a decreasing to slowly increasing trend in the context of a series of ecological restoration measures, scientific ecological protection and development policies must be continuously implemented to achieve harmony between ecological service improvement and urbanization development. Our results provide important information for making land-use decisions and facilitating sustainable development in ecologically protected basins.

In the context of the rapid progress of global urbanization, the massive encroachment of social landscapes into ecological and productive landscapes has led to a series of environmental problems. Furthermore, analyzing the landscape resilience could effectively reveal the sustainable development ability of the urban landscape. This study establishes a social-ecological productive landscape resilience (SEPLR) evaluation system and reveals trade-offs and synergies between different landscape types and resilience. Finally, this study provides landscape management zonings based on the spatial and temporal dynamic characteristics of landscape resilience and subsystem resilience. The findings showed that: (1) The CUAG has significant landscape heterogeneity and change drastically, which is mainly manifested by the massive encroachment of social landscape into productive landscape. (2) The SEPLR of CUAG decreased slightly by 0.75 % over the decade, with significant changes of spatial distribution. (3) The comprehensive remediation areas and social development areas are the dominant management zones. The findings could be incorporated into the decision-making of land use trade-off development in CUAG to promote the coordinated development of social-ecological productive systems and improve the sustainability of urban landscape.

Abstract Immune checkpoint inhibitor (ICI) rechallenge in non‐small cell lung cancer (NSCLC) is a promising therapeutic strategy. The situation for ICI rechallenge can be divided into three categories: adverse events (AEs); resistance to ICIs, and rechallenge becomes compulsive because of tumor relapse while the patients had completed a 2 year course of immunotherapy. However, these categories are still controversial and should be explored further. Through voting at the 6th Straits Summit Forum on Lung Cancer, in this study we summarize the consensus of 147 experts in ICI rechallenges. A total of 97.74% experts agreed to rechallenge; 48.87% experts rechallenge with the original drug, and the others rechallenge with a different drug; 40.3% agreed to rechallenge directly after progression; 88.06% experts agreed to ICI rechallenge with a combination regimen; and factors such as previous performance status score, PD‐1 expression, and age should also be considered. Understanding the the clinical studies in ICI rechallenge could bring us one step closer to understanding the consensus. In patients with advanced NSCLC who have suffered recurrent or distant metastasis after immunotherapy, the option of rechallenge with ICIs is a promising treatment option.

Abstract Background Cervical cancer (CC) causes more than 311,000 deaths annually worldwide. The integration of human papillomavirus (HPV) is a crucial genetic event that contributes to cervical carcinogenesis. Despite HPV DNA integration is known to disrupt the genomic architecture of both the host and viral genomes in CC, the complexity of this process remains largely unexplored. Results In this study, we conducted whole-genome sequencing (WGS) at 55-65X coverage utilizing the PacBio long-read sequencing platform in SiHa and HeLa cells, followed by comprehensive analyses of the sequence data to elucidate the complexity of HPV integration. Firstly, our results demonstrated that PacBio long-read sequencing effectively identifies HPV integration breakpoints with comparable accuracy to targeted-capture Next-generation sequencing (NGS) methods. Secondly, we constructed detailed models of complex integrated genome structures that included both the HPV genome and nearby regions of the human genome by utilizing PacBio long-read WGS. Thirdly, our sequencing results revealed the occurrence of a wide variety of genome-wide structural variations (SVs) in SiHa and HeLa cells. Additionally, our analysis further revealed a potential correlation between changes in gene expression levels and SVs on chromosome 13 in the genome of SiHa cells. Conclusions Using PacBio long-read sequencing, we have successfully constructed complex models illustrating HPV integrated genome structures in SiHa and HeLa cells. This accomplishment serves as a compelling demonstration of the valuable capabilities of long-read sequencing in detecting and characterizing HPV genomic integration structures within human cells. Furthermore, these findings offer critical insights into the complex process of HPV16 and HPV18 integration and their potential contribution to the development of cervical cancer.

Abstract Despite the central role of human leukocyte antigen class I (HLA-I) in tumor neoantigen presentation, quantitative determination of presentation capacity remains elusive. Based on a pooled pan-cancer genomic dataset of 885 patients treated with immune checkpoint inhibitors (ICIs), we developed a score integrating the binding affinity of neoantigens to HLA-I, as well as HLA-I allele divergence, termed the HLA tumor-Antigen Presentation Score (HAPS). Patients with a high HAPS were more likely to experience survival benefit following ICI treatment. Analysis of the tumor microenvironment indicated that the antigen presentation pathway was enriched in patients with a high HAPS. Finally, we built a neural network incorporating factors associated with neoantigen production, presentation, and recognition, which exhibited potential for differentiating cancer patients likely to benefit from ICIs. Our findings highlight the clinical utility of evaluating HLA-I tumor antigen presentation capacity and describe how ICI response may depend on HLA-mediated immunity.

The fusion genes NRG1 and NRG2, members of the epidermal growth factor (EGF) receptor family, have emerged as key drivers in cancer. Upon fusion, NRG1 retains its EGF-like active domain, binds to the ERBB ligand family, and triggers intracellular signaling cascades, promoting uncontrolled cell proliferation. The incidence of NRG1 gene fusion varies across cancer types, with lung cancer being the most prevalent at 0.19 to 0.27%. CD74 and SLC3A2 are the most frequently observed fusion partners. RNA-based next-generation sequencing is the primary method for detecting NRG1 and NRG2 gene fusions, whereas pERBB3 immunohistochemistry can serve as a rapid prescreening tool for identifying NRG1-positive patients. Currently, there are no approved targeted drugs for NRG1 and NRG2. Common treatment approaches involve pan-ERBB inhibitors, small molecule inhibitors targeting ERBB2 or ERBB3, and monoclonal antibodies. Given the current landscape of NRG1 and NRG2 in solid tumors, a consensus among diagnostic and treatment experts is proposed, and clinical trials hold promise for benefiting more patients with NRG1 and NRG2 gene fusion solid tumors.

The sanding process caused by karstification in dolomite creates a special sandy dolomite stratum, where the frequent catastrophic instability of the surrounding rock occurred during tunnel construction. In this study, the micro-origin and macro-performance of the sandy dolomite stratum are first discussed. Then, a numerical model based on the coupling method between the discontinuous deformation analysis and smoothed particle hydrodynamics is proposed to depict the heterogeneous dolomite formation with different sanding degrees. Following, the mechanical behaviors of the heterogeneous dolomite samples under uniaxial compression are studied after calibrating the numerical parameters with the two single materials sampled from the tunnel site respectively. Further, the instability disasters of the dolomite surrounding rock with different sanding degrees are reproduced, and the failure behaviors of tunnels are explained with respect to the stress distribution and plastic zone. The obtained results show that the rotation and dislocation of the remained dolomite block contribute to the unsmooth stress–strain curve and deterioration in uniaxial compressive strength. However, the block serves as the skeleton in the transmission of field stress in underground space, which improves the stability of the formation.

Abstract Immune checkpoint inhibitors (PD‐1/PD‐L1 and CTLA‐4 blockade) have revolutionized the treatment landscape in non‐small cell lung cancer (NSCLC). Secondary resistance to immunotherapy (IO), which poses a substantial challenge in clinical settings, occurs in several initial responders. Currently, new treatment approaches have been extensively evaluated in investigational studies for these patients to tackle this difficult problem; however, the lack of consistency in clinical definition, uniform criteria for enrollment in clinical trials, and interpretation of results remain significant hurdles to progress. Thus, our expert panel comprehensively synthesized data from current studies to propose a practical clinical definition of secondary resistance to immunotherapy in NSCLC in metastatic and neoadjuvant settings. In addition to patients who received IO alone (including IO‐IO combinations), we also generated a definition for patients treated with chemotherapy plus IO. This consensus aimed to provide guidance for clinical trial design and facilitate future discussions with investigators. It should be noted that additional updates in this consensus are required when new data is available.

Abstract Aims To investigate the predictive value of baseline C-reactive protein (CRP) levels on the efficacy of chemotherapy plus immune checkpoint inhibitors (ICI) in patients with advanced lung squamous cell carcinoma (LSCC). Materials and methods In this retrospective multicenter study spanning from January 2016 to December 2020, advanced LSCC patients initially treated with chemotherapy or a combination of chemotherapy and ICI were categorized into normal and elevated CRP subgroups. The relationship between CRP levels and treatment outcomes was analyzed using multivariate Cox proportional hazards models and multivariate logistic regression, focusing primarily on the progression-free survival (PFS) endpoint, and secondarily on overall survival (OS) and objective response rate (ORR) endpoints. Survival curves were generated using the Kaplan-Meier method, with the log-rank test used for comparison between groups. Results Of the 245 patients evaluated, the 105 who received a combination of chemotherapy and ICI with elevated baseline CRP levels exhibited a significant reduction in PFS (median 6.5 months vs. 11.8 months, HR, 1.78; 95% CI: 1.12–2.81; p = 0.013) compared to those with normal CRP levels. Elevated CRP was identified as an independent risk factor for poor PFS through multivariate-adjusted analysis. However, among the 140 patients receiving chemotherapy alone, baseline CRP levels did not significantly influence PFS. Furthermore, within the combination therapy group, there was a notable decrease in the ORR (51% vs. 71%, p = 0.035), coupled with a significantly shorter OS (median 20.9 months vs. 31.5 months, HR, 2.24; 95% CI: 1.13–4.44; p = 0.033). Conclusion In patients with advanced LSCC, elevated baseline CRP levels were identified as an independent predictive factor for the efficacy of combination therapy with chemotherapy and ICI, but not in chemotherapy alone. This suggests that CRP may be a valuable biomarker for guiding treatment strategies.

Three-dimensional (3D) Scene Understanding achieves environmental perception by extracting and analyzing point cloud data with wide applications including virtual reality, robotics, etc. Previous methods align the 2D image feature from a pre-trained CLIP model and the 3D point cloud feature for the open vocabulary scene understanding ability. We believe that existing methods have the following two deficiencies: (1) the 3D feature extraction process ignores the challenges of real scenarios, i.e., point cloud data are very sparse and even incomplete; (2) the training stage lacks direct text supervision, leading to inconsistency with the inference stage. To address the first issue, we employ a Masked Consistency training policy. Specifically, during the alignment of 3D and 2D features, we mask some 3D features to force the model to understand the entire scene using only partial 3D features. For the second issue, we generate pseudo-text labels and align them with the 3D features during the training process. In particular, we first generate a description for each 2D image belonging to the same 3D scene and then use a summarization model to fuse these descriptions into a single description of the scene. Subsequently, we align 2D-3D features and 3D-text features simultaneously during training. Massive experiments demonstrate the effectiveness of our method, outperforming state-of-the-art approaches.

Abstract The rearranged during transfection (RET) gene is one of the receptor tyrosine kinases and cell‐surface molecules responsible for transmitting signals that regulate cell growth and differentiation. In non‐small cell lung cancer (NSCLC), RET fusion is a rare driver gene alteration associated with a poor prognosis. Fortunately, two selective RET inhibitors (sRETi), namely pralsetinib and selpercatinib, have been approved for treating RET fusion NSCLC due to their remarkable efficacy and safety profiles. These inhibitors have shown the ability to overcome resistance to multikinase inhibitors (MKIs). Furthermore, ongoing clinical trials are investigating several second‐generation sRETis that are specifically designed to target solvent front mutations, which pose a challenge for first‐generation sRETis. The effective screening of patients is the first crucial step in the clinical application of RET‐targeted therapy. Currently, four methods are widely used for detecting gene rearrangements: next‐generation sequencing (NGS), reverse transcription‐polymerase chain reaction (RT‐PCR), fluorescence in situ hybridization (FISH), and immunohistochemistry (IHC). Each of these methods has its advantages and limitations. To streamline the clinical workflow and improve diagnostic and treatment strategies for RET fusion NSCLC, our expert group has reached a consensus. Our objective is to maximize the clinical benefit for patients and promote standardized approaches to RET fusion screening and therapy.

Objective: Immune checkpoint inhibitors (ICIs) targeting programmed cell death-1/ligand-1 (PD-1/PD-L1), cytotoxic T lymphocyte antigen-4 (CTLA-4), and lymphocyte-activation gene-3 (LAG-3) have been widely studied and applied throughout the course of cancer treatment. This study aimed to provide a comprehensive profile of ICI-associated toxicity and elucidate the toxicity patterns of ICIs across different treatment lines. Methods: In total, 155 cohorts comprising 24 539 eligible patients were included in the safety analysis. Trial name, registration number, cancer type, trial phase, clinical setting, trial design, regimen, dosing schedule, age, sex and ethnicity distributions, number of patients, number of treatment-related adverse events (trAEs), and number of treatment-related death were extracted. We defined a timeline from the neoadjuvant setting to the third-line setting. We also introduced a synthesizing principle for adverse event rates (SPAER) of immunotherapy to ensure the comparability and reliability across different treatment lines. The study protocol was registered and approved by the PROSPERO protocol review committee (CRD42021242368). Results: After excluding the neoadjuvant setting group, we observed a distinct reduction in the incidence of treatment-related adverse events (trAEs) with an advancement of the line of ICI treatment. The incidence of trAEs was negatively correlated with the line of treatment, irrespective of whether monotherapy or dual-ICI combination therapy was administered. Sensitivity analyses also confirmed the coincident negative correlations. Conclusion: In summary, using a timeline-based concept centered around treatment lines, we revealed the dynamic landscape of ICI-associated toxicity and found that patients treated with ICIs during later lines of therapy may have a lower risk of trAEs.

Abstract Multimodal epigenetic characterization of cell-free DNA (cfDNA) could improve the performance of blood-based early cancer detection. However, integrative profiling of cfDNA methylome and fragmentome has been technologically challenging. Here, we adapt an enzyme-mediated methylation sequencing method for comprehensive analysis of genome-wide cfDNA methylation, fragmentation, and copy number alteration (CNA) characteristics for enhanced cancer detection. We apply this method to plasma samples of 497 healthy controls and 780 patients of seven cancer types and develop an ensemble classifier by incorporating methylation, fragmentation, and CNA features. In the test cohort, our approach achieves an area under the curve value of 0.966 for overall cancer detection. Detection sensitivity for early-stage patients achieves 73% at 99% specificity. Finally, we demonstrate the feasibility to accurately localize the origin of cancer signals with combined methylation and fragmentation profiling of tissue-specific accessible chromatin regions. Overall, this proof-of-concept study provides a technical platform to utilize multimodal cfDNA features for improved cancer detection.

Summary: Background: The high heterogeneity of tumour and the complexity of tumour microenvironment (TME) greatly impacted the tumour development and the prognosis of cancer in the era of immunotherapy. In this study, we aimed to portray the single cell-characterised landscape of lung adenocarcinoma (LUAD), and develop an integrated signature incorporating both tumour heterogeneity and TME for prognosis stratification. Methods: Single-cell tagged reverse transcription sequencing (STRT-seq) was performed on tumour tissues and matched normal tissues from 14 patients with LUAD for immune landscape depiction and candidate key genes selection for signature construction. Kaplan–Meier survival analyses and in-vitro cell experiments were conducted to confirm the gene functions. The transcriptomic profile of 1949 patients from 11 independent cohorts including nine public datasets and two in-house cohorts were obtained for validation. Findings: We selected 11 key genes closely related to cell-to-cell interaction, tumour development, T cell phenotype transformation, and Ma/Mo cell distribution, including HLA-DPB1, FAM83A, ITGB4, OAS1, FHL2, S100P, FSCN1, SFTPD, SPP1, DBH-AS1, CST3, and established an integrated 11-gene signature, stratifying patients to High-Score or Low-Score group for better or worse prognosis. Moreover, the prognostically-predictive potency of the signature was validated by 11 independent cohorts, and the immunotherapeutic predictive potency was also validated by our in-house cohort treated by immunotherapy. Additionally, the in-vitro cell experiments and drug sensitivity prediction further confirmed the gene function and generalizability of this signature across the entire RNA profile spectrum. Interpretation: This single cell-characterised 11-gene signature might offer insights for prognosis stratification and potential guidance for treatment selection. Funding: Support for the study was provided by National key research and development project (2022YFC2505004, 2022YFC2505000 to Z.W. and J.W.), Beijing Natural Science Foundation (7242114 to J.X.), National Natural Science Foundation of China of China (82102886 to J.X., 81871889 and 82072586 to Z.W.), Beijing Nova Program (20220484119 to J.X.), NSFC general program (82272796 to J.W.), NSFC special program (82241229 to J.W.), CAMS Innovation Fund for Medical Sciences (2021-1-I2M-012, 2022-I2M-1-009 to Z.W. and J.W.), Beijing Natural Science Foundation (7212084 to Z.W.), CAMS Key lab of translational research on lung cancer (2018PT31035 to J.W.), Aiyou Foundation (KY201701 to J.W.). Medical Oncology Key Foundation of Cancer Hospital Chinese Academy of Medical Sciences (CICAMS-MOCP2022003 to J.X.)

In organic solar cells, the singlet and triplet excitons dissociate into free charge carriers with different mechanisms due to their opposite spin state. Therefore, the ratio of the singlet and triplet excitons directly affects the photocurrent. Many methods were used to optimize the performance of the low-efficiency solar cell by improving the ratio of triplet excitons, which shows a long diffusion length. Here we observed that in high-efficiency systems, the proportion of singlet excitons under linearly polarized light excitation is higher than that of circularly polarized light. Since the singlet charge transfer state has lower binding energy than the triplet state, it makes a significant contribution to the charge carrier generation and enhancement of the photocurrent. Further, the positive magnetic field effect reflects that singlet excitons dissociation plays a major role in the photocurrent, which is opposite to the case of low-efficiency devices where triplet excitons dominate the photocurrent.

Summary: Background: In recent years, a growing number of patients with multiple primary lung cancer (MPLC) are being diagnosed, and a subset of these patients is found to have a large number of lesions at the time of diagnosis, which are referred to as ‘super MPLC’. Methods: Here, we perform whole exome sequencing (WES) and immunohistochemistry (IHC) analysis of PD-L1 and CD8 on 212 tumor samples from 42 patients with super MPLC. Findings: We report the genomic alteration landscape of super MPLC. EGFR, RBM10 and TP53 mutation and TERT amplification are important molecular events in the evolution of super MPLC. We propose the conception of early intrapulmonary metastasis, which exhibits different clinical features from conventional metastasis. The IHC analyses of PD-L1 and CD8 reveal a less inflamed microenvironment of super MPLC than that of traditional non-small cell lung cancer (NSCLC). We identify the potentially susceptible germline mutations for super MPLC. Interpretation: Our study depicts the genomic characteristics and immune landscape, providing insights into the pathogenesis and possible therapeutic guidance of super MPLC. Funding: A full list of funding bodies that supported this study can be found in the Acknowledgements section.

Abstract Graphitic carbon nitride (g‐C3N4) has been extensively doped with alkali metals to enlarge photocatalytic output, in which cesium (Cs) doping is predicted to be the most efficient. Nevertheless, the sluggish diffusion and doping kinetics of precursors with high melting points, along with imprecise regulation, have raised the debate on whether Cs doping could make sense. For this matter, we attempt to confirm the positive effects of Cs doping on multifunctional photocatalysis by first using cesium acetate with the character of easy manipulation. The optimized Cs‐doped g‐C3N4 (CCN) shows a 41.6‐fold increase in visible‐light‐driven hydrogen evolution reaction (HER) compared to pure g‐C3N4 and impressive degradation capability, especially with 77% refractory tetracycline and almost 100% rhodamine B degraded within an hour. The penetration of Cs+ is demonstrated to be a mode of interlayer doping, and Cs–N bonds (especially with sp2 pyridine N in C═N–C), along with robust chemical interaction and electron exchange, are fabricated. This atomic configuration triggers the broadened spectral response, the improved charge migration, and the activated photocatalytic capacity. Furthermore, we evaluate the CCN/cadmium sulfide hybrid as a Z‐scheme configuration, promoting the visible HER yield to 9.02 mmol g−1 h−1, which is the highest ever reported among all CCN systems. This work adds to the rapidly expanding field of manipulation strategies and supports further development of mediating served for photocatalysis.

Abstract Ionic liquids provide versatile pathways for controlling the structures and properties of quantum materials. Previous studies have reported electrostatic gating of nanometer-thick flakes leading to emergent superconductivity, insertion or extraction of protons and oxygen ions in perovskite oxide films enabling the control of different phases and material properties, and intercalation of large-sized organic cations into layered crystals giving access to tailored superconductivity. Here, we report an ionic-liquid gating method to form three-dimensional transition metal monochalcogenides (TMMCs) by driving the metals dissolved from layered transition metal dichalcogenides (TMDCs) into the van der Waals gap. We demonstrate the successful self-intercalation of PdTe2 and NiTe2, turning them into high-quality PdTe and NiTe single crystals, respectively. Moreover, the monochalcogenides exhibit distinctive properties from dichalcogenides. For instance, the self-intercalation of PdTe2 leads to the emergence of superconductivity in PdTe. Our work provides a synthesis pathway for TMMCs by means of ionic liquid gating driven self-intercalation.

Abstract Background Osimertinib is the first‐line treatment for patients with epidermal growth factor receptor (EGFR) mutations, but the treatment options after drug resistance are limited. Previous studies have suggested that EGFR is in an immunosuppressive tumor immune microenvironment (TIME). However, the evolution of TIME after osimertinib resistance and whether this resistance can be overcome by targeting TIME needs to be further investigated. Methods The remodeling process and mechanism of TIME during the treatment with osimertinib were studied. Results The proportion of EGFRL858R+T790M mutant tumor immune infiltrating cells was extremely low. Osimertinib treatment transiently triggered inflammatory cells, but several immunosuppressive cells infiltrated after drug resistance and formed a myeloid‐derived suppressor cell (MDSC)‐enriched TIME. The programmed cell death protein‐1 monoclonal antibody was not able to reverse the MDSC‐enriched TIME. Further analysis revealed that the activation of nuclear factor‐kappa B (NF‐κB) and mitogen‐activated protein kinase (MAPK) pathways recruited a large number of MDSCs via cytokines. Finally, MDSC secreted high levels of interleukin‐10 and arginase‐1 and created an immunosuppressive TIME. Conclusions Thus, our findings lay the foundation for the evolution of TIME in osimertinib treatment, establish the mechanism of immunosuppressive TIME after osimertinib resistance, and propose potential solutions.

Abstract Background Diabetic retinopathy (DR) development is associated with disturbances in the gut microbiota and related metabolites. Butyric acid is one of the short-chain fatty acids (SCFAs), which has been found to possess a potential antidiabetic effect. However, whether butyrate has a role in DR remains elusive. This study aimed to investigate the effect and mechanism of sodium butyrate supplementation on DR. Methods C57BL/6J mice were divided into three groups: Control group, diabetic group, and diabetic with butyrate supplementation group. Type 1 diabetic mouse model was induced by streptozotocin. Sodium butyrate was administered by gavage to the experimental group daily for 12 weeks. Optic coherence tomography, hematoxylin–eosin, and immunostaining of whole-mount retina were used to value the changes in retinal structure. Electroretinography was performed to assess the retinal visual function. The tight junction proteins in intestinal tissue were evaluated using immunohistochemistry. 16S rRNA sequencing and LC–MS/MS were performed to determine the alteration and correlation of the gut microbiota and systemic SCFAs. Results Butyrate decreased blood glucose, food, and water consumption. Meanwhile, it alleviated retinal thinning and activated microglial cells but improved electroretinography visual function. Additionally, butyrate effectively enhanced the expression of ZO-1 and Occludin proteins in the small intestine. Crucially, only butyric acid, 4-methylvaleric acid, and caproic acid were significantly decreased in the plasma of diabetic mice and improved after butyrate supplementation. The deeper correlation analysis revealed nine genera strongly positively or negatively correlated with the above three SCFAs. Of note, all three positively correlated genera, including norank_f_Muribaculaceae, Ileibacterium, and Dubosiella, were significantly decreased in the diabetic mice with or without butyrate treatment. Interestingly, among the six negatively correlated genera, Escherichia-Shigella and Enterococcus were increased, while Lactobacillus, Bifidobacterium, Lachnospiraceae_NK4A136_group, and unclassified_f_Lachnospiraceae were decreased after butyrate supplementation. Conclusion Together, these findings demonstrate the microbiota regulating and diabetic therapeutic effects of butyrate, which can be used as a potential food supplement alternative to DR medicine.

Highlights A comprehensive summary of the representative promising applications of metal halide perovskite materials, including traditional optoelectronic devices (solar cells, light-emitting diodes, photodetectors, lasers), and cutting-edge technologies in terms of neuromorphic devices (artificial synapses and memristors) and pressure-induced emission. For each application, the fundamentals of the field, the current progress and the remaining challenges are provided, based on the up-to-date works.

This is a paper in the field of mineral processing engineering. The mineral characteristics of a vanadium titanium iron concentrate sample from Panxi were studied using sieve analysis, polarizing microscope, X-ray diffractometer, Zeiss Sigma 500 scanning electron microscope, Bruker energy spectrometer, and AMICS automatic mineral analysis system. The main gangue minerals in the sample are magnetite pyrite, granular ilmenite, pyroxene, feldspar, etc. The contents of coarse and fine products TFe, S, SiO2, Al2O3, MgO, and gangue minerals are quite different. A small amount of Fe exists in ilmenite, magnetic pyrite, and non-metallic minerals. Ti mainly exists in the form of titanium magnetite. ilmenite and magnesium aluminum spinel are inlaid on the base of titanium magnetite in lamellar, veinlet, thin strip, grid, and needle shapes, The particle size of the guest crystal mineral is very fine, making it difficult to grind, separate, and post treat the product. The use of grinding magnetic separation can increase the TFe grade of vanadium titanium iron concentrate by 2-3 percentage points. The essence of the improvement is a significant decrease in the content of SiO2, Al2O3, and MgO in the concentrate, with a decrease of SiO2>MgO>Al2O3. The TiO2 content of the concentrate does not change much during the improvement process, with Fe/TiO2 increasing from 4.29 to 4.50, V2O5 grade slightly increasing, and S grade slightly decreasing.

Despite ongoing research efforts aimed at understanding the structural response of steel fiber reinforced concrete (SFRC), there is very limited research on the failure characteristics and mesoscopic damage mechanism of SFRC, specifically when under flexure. In this study, a four-point bending test of plain concrete (PC) and SFRC with different fiber contents is carried out to investigate the flexural performance of SFRC. The crack propagation process, cracking load, ultimate load, and load-deflection curves of PC and SFRC beams are obtained. Additionally, the discrete element method (DEM), using PFC2D 6.0 software, is adopted to explore the mesoscopic properties of PC and SFRC. The test and simulation results of PC and SFRC beams are compared and analyzed, and some conclusions are drawn. The results show that steel fiber can efficiently improve the compressive strength of concrete when the fiber content is 30 kg/m3, and significantly improve the deformation resistance, crack resistance, and flexural capacity of concrete. The refined numerical models of PC and SFRC beams are established based on compressive strength and aggregate screening results. Through the numerical four-point bending test, the mesoscopic mechanical behaviors of models reveal the damage mechanism of SFRC. The horizontally distributed steel fibers bridge both sides of the cracks to resist crack development, and the vertically distributed steel fibers guide the cracks to the place with strong contact, thus resisting crack height development. The test results show that, for flexural properties, the optimal steel fiber content of SFRC is 31 kg/m3.

Clinical ketosis is a detrimental metabolic disease in dairy cows, often accompanied by severe lipolysis and inflammation in adipose tissue. Our previous study suggested a 2.401-fold upregulation in the calmodulin (CaM) level in the adipose tissue of cows with clinical ketosis. Therefore, we hypothesized that CaM may regulate lipolysis and inflammatory responses in cows with clinical ketosis. To verify the hypothesis, we conducted a thorough veterinary assessment of clinical symptoms and serum β-hydroxybutyrate (BHB) concentration. Subsequently, we collected subcutaneous adipose tissue samples from six healthy and six clinically ketotic Holstein cows at 17 ± 4 days postpartum. Commercial kits were used to test the abundance of BHB, non-esterified fatty acid (NEFA), the liver function index (LFI), interleukin-6 (IL-6), IL-1β, and tumor necrosis factor-α (TNF-α). We found that cows with clinical ketosis exhibited higher levels of BHB, NEFA, LFI, IL-6, IL-1β, TNF-α, and lower glucose levels than healthy cows. Furthermore, the abundance of CaM, toll-like receptor 4 (TLR4), inhibitor of nuclear factor κB kinase subunit β (IKK), phosphorylated nuclear factor κB p65/nuclear factor κB p65 (p-NF-κB p65/NF-κB p65), adipose triacylglycerol lipase (ATGL), and phosphorylated hormone-sensitive lipase/hormone-sensitive lipase (p-HSL/HSL) was increased, while that of perilipin-1 (PLIN1) was decreased in the adipose tissue of cows with clinical ketosis. To investigate the mechanism underlying the responses, we isolated the primary bovine adipocytes from the adipose tissue of healthy cows and induced the inflammatory response mediated by TLR4/IKK/NF-κB p65 with lipopolysaccharide (LPS). Additionally, we treated the primary bovine adipocytes with CaM overexpression adenovirus and CaM small interfering RNA. In vitro, LPS upregulated the abundance of TLR4, IKK, p-NF-κB p65, ATGL, p-HSL/HSL, and CaM and downregulated PLIN1. Furthermore, CaM silencing downregulated the abundance of LPS-activated p-HSL/HSL, TLR4, IKK, and p-NF-κB p65 and upregulated PLIN1 in bovine adipocytes, except for ATGL. However, CaM overexpression upregulated the abundance of LPS-activated p-HSL/HSL, TLR4, IKK, and p-NF-κB p65 and downregulated PLIN1 expression in bovine adipocytes. These data suggest that CaM promotes lipolysis in adipocytes through HSL and PINL1 while activating the TLR4/IKK/NF-κB inflammatory pathway to stimulate an inflammatory response. There is a positive feedback loop between CaM, lipolysis, and inflammation. Inhibiting CaM may act as an adaptive mechanism to alleviate metabolic dysregulation in adipose tissue, thereby relieving lipolysis and inflammatory responses.

The management of brain tumors presents numerous challenges, despite the employment of multimodal therapies including surgical intervention, radiotherapy, chemotherapy, and immunotherapy. Owing to the distinct location of brain tumors and the presence of the blood–brain barrier (BBB), these tumors exhibit considerable heterogeneity and invasiveness at the histological level. Recent advancements in hydrogel research for the local treatment of brain tumors have sought to overcome the primary challenge of delivering therapeutics past the BBB, thereby ensuring efficient accumulation within brain tumor tissues. This article elaborates on various hydrogel-based delivery vectors, examining their efficacy in the local treatment of brain tumors. Additionally, it reviews the fundamental principles involved in designing intelligent hydrogels that can circumvent the BBB and penetrate larger tumor areas, thereby facilitating precise, controlled drug release. Hydrogel-based drug delivery systems (DDSs) are posited to offer a groundbreaking approach to addressing the challenges and limitations inherent in traditional oncological therapies, which are significantly impeded by the unique structural and pathological characteristics of brain tumors.

Abstract Background In China, over 50% of lung cancer cases occur in nonsmokers. Thus, identifying high‐risk individuals for targeted lung cancer screening is crucial. Beyond age and smoking, determining other risk factors for lung cancer in the Asian population has become a focal point of research. Using 30,000 participants in the prospectively enrolled cohort at China's National Cancer Center (NCC) over the past 14 years, we categorized participants by risk, with an emphasis on nonsmoking females. Materials and Methods Between November 2005 and December 2019, 31,431 individuals voluntarily underwent low‐dose computed tomography (LDCT) scans for lung cancer screening at the NCC. We recorded details like smoking history, exposure to hazards, and family history of malignant tumors. Using the 2019 NCCN criteria, participants were categorized into high‐, moderate‐, and low‐risk groups. Additionally, we separated non‐high‐risk groups into female never smokers (aged over 40) exposed to second‐hand smoke (SHS) and others. Any positive results from initial scans were monitored per the I‐ELCAP protocol (2006), and suspected malignancies were addressed through collaborative decisions between patients and physicians. We analyzed and compared the detection rates of positive results, confirmed lung cancers, and cancer stages across risk, age, and gender groups. Results Out of 31,431 participants (55.9% male, 44.1% female), 3695 (11.8%) showed positive baseline LDCT scans with 197 (0.6%; 106 females, 91 males) confirmed as lung cancer cases pathologically. Malignancy rate by age was 0.1% among those aged under 40 years, 0.4% among those aged 40–49 years, 0.8% among those aged 50–59 years, and 1.2% among those aged 60 years and older. From the 25,763 participants (56.9% male, 43.1% female) who completed questionnaires, 1877 (7.3%) were categorized as high risk, 6500 (25.2%) as moderate risk, and 17,386 (67.5%) as low risk. Of the 23,886 in the non‐high‐risk category, 8041 (33.7%) were females over 40 years old exposed to SHS. The high‐risk group showed the highest lung cancer detection rate at 1.4%. However, females exposed to SHS had a notably higher detection rate than the rest of the non‐high‐risk group (1.1% vs. 0.5%; p

BackgroundImmune checkpoint inhibitors (ICIs) have revolutionized the treatment landscape for locally advanced non-small-cell lung cancer (LA-NSCLC), whereas responses to anti-programmed cell death-1 (PD-1) or anti-programmed death-ligand 1 (PD-L1) are heterogeneous. Though consolidation ICI following concurrent chemoradiotherapy (cCRT) improves survival of NSCLC, this regimen is challenging for patients with bulky tumors due to excessive target volumes and radiation-resistant hypoxia during upfront cCRT, leading to higher risk of pneumonitis and inferior local-regional control. Recent trials have demonstrated neoadjuvant ICI brought greater benefit to stage III than stage I-II NSCLC. Our previous study also supported the therapeutic advantage of 2-cycle induction ICI for patients with bulky unresectable stage III NSCLC. In the context of induction immunotherapy, radiotherapy is more likely to exert immune synergistic effects, reverse anti-PD-1 resistance, and activate abscopal immune responses. Prospective trials to determine the efficacy and safety of induction ICI for bulky LA-NSCLC are necessary.MethodsThis randomized, open-label, two-arm phase II study aims to explore whether 2 cycles of induction anti-PD-1 toripalimab plus chemotherapy can improve progression-free survival (PFS) in bulky LA-NSCLC. Bulky tumors are defined as primary lesion ≥5 cm in greatest dimension or metastatic lymph nodes ≥2 cm in shortest diameter. A total of 50 patients with bulky unresectable stage III NSCLC will be recruited and 1:1 randomized into the experimental arm: 2-cycle induction PD-1 inhibitor toripalimab plus chemotherapy followed by cCRT and consolidation toripalimab; or control arm: 2-cycle induction chemotherapy followed by cCRT and consolidation toripalimab. Patients are stratified by pathology (squamous versus non-squamous). The primary endpoint is PFS. Secondary endpoints are overall survival, overall response rate, disease control rate, duration of response, and incidence of adverse events. Exploratory analyses include PD-L1 expression and liquid biopsy-based biomarker testing, tumor microenvironment profiling at single-cell levels, and quality-of-life assessments.DiscussionThe InTRist study is the first randomized phase II trial to investigate the feasibility of induction anti-PD-1 toripalimab plus chemotherapy followed by cCRT and consolidation toripalimab in bulky LA-NSCLC, providing novel evidence for the synergistic strategy combining anti-PD-1 blockade with radiotherapy to prolong immunotherapy benefits, overcome resistance, and enhance abscopal immune response.Clinical trial registrationClinicalTrials.gov, identifier NCT05888402.

Background: Rearranged during transfection (RET) gene fusion is a target for non-small cell lung cancer (NSCLC) treatment, and RET inhibitors are approved for advanced NSCLC. The role of immune checkpoint inhibitors (ICIs) in RET fusion-positive NSCLC remains controversial. This retrospective study analyzed the efficacy of ICIs and RET inhibitors in Chinese patients with RET fusion-positive NSCLC. Methods: Data from patients diagnosed with advanced NSCLC harboring RET fusion from Jan 2017 to Sep 2021 were analyzed. Clinicopathological characteristics and outcomes of ICIs and RET inhibitors treatments were collected. Results: Seventy-five patients with RET fusion-positive advanced NSCLC were identified. The median age of patients was 57 years, half of the patients were female (50.3%), and most were non-smokers or light smokers (72%). Of the cancer types diagnosed in study patients, the KIF5B-RET fusion subtype accounted for 73.3% (55/75), twelve patients (16%) had CCDC6-RET fusion, and three (4%) had NCOA4-RET fusion. Sixteen patients were treated with ICIs. In previously untreated patients, we observed an objective response rate (ORR) of 71.4% and median progression free survival (PFS) of 7.5 months in seven assessable patients. Of four patients with PD-L1 overexpression (>50%) one received pembrolizumab and the other three patients received pemetrexed, carboplatin, and pembrolizumab or camrelizumab. In these patients, the ORR was 75% and disease control rate was 100%. Fifteen patients received selective RET inhibitors (pralsetinib and selpercatinib), resulting in an ORR of 53.3% (8/15) and median PFS of 10.0 months (95% CI 5.2–14.9). Conclusions: ICIs for PD-L overexpression and treatment naive patients offer comparable benefits for RET fusion-positive NSCLC, warranting further investigation.

Abstract Developing efficient noble-metal-free surface-enhanced Raman scattering (SERS) substrates and unveiling the underlying mechanism is crucial for ultrasensitive molecular sensing. Herein, we report a facile synthesis of mixed-dimensional heterostructures via oxygen plasma treatments of two-dimensional (2D) materials. As a proof-of-concept, 1D/2D WO3-x /WSe2 heterostructures with good controllability and reproducibility are synthesized, in which 1D WO3-x nanowire patterns are laterally arranged along the three-fold symmetric directions of 2D WSe2. The WO3-x/WSe2 heterostructures exhibited high molecular sensitivity, with a limit of detection of 5 × 10−18 M and an enhancement factor of 5.0 × 1011 for methylene blue molecules, even in mixed solutions. We associate the ultrasensitive performance to the efficient charge transfer induced by the unique structures of 1D WO3-x nanowires and the effective interlayer coupling of the heterostructures. We observed a charge transfer timescale of around 1.0 picosecond via ultrafast transient spectroscopy. Our work provides an alternative strategy for the synthesis of 1D nanostructures from 2D materials and offers insights on the role of ultrafast charge transfer mechanisms in plasmon-free SERS-based molecular sensing.

Abstract Aqueous Zn-ion batteries have attracted increasing research interest; however, the development of these batteries has been hindered by several challenges, including dendrite growth, Zn corrosion, cathode material degradation, limited temperature adaptability and electrochemical stability window, which are associated with water activity and the solvation structure of electrolytes. Here we report that water activity is suppressed by increasing the electron density of the water protons through interactions with highly polar dimethylacetamide and trimethyl phosphate molecules. Meanwhile, the Zn corrosion in the hybrid electrolyte is mitigated, and the electrochemical stability window and the operating temperature of the electrolyte are extended. The dimethylacetamide alters the surface energy of Zn, guiding the (002) plane dominated deposition of Zn. Molecular dynamics simulation evidences Zn2+ ions are solvated with fewer water molecules, resulting in lower lattice strain in the NaV3O8·1.5H2O cathode during the insertion of hydrated Zn2+ ions, boosting the lifespan of Zn|| NaV3O8·1.5H2O cell to 3000 cycles.

High-temperature wear is a common wear loss in medium heat-resistant hot-work die steels. In this study, NbC-reinforced 4Cr5MoSiV1 composites were prepared by using an in situ method to increase their high-temperature wear resistance. SEM, EBSD, and TEM were used to analyze the morphology, distribution, and microstructure of NbC in composites with different NbC volume fractions. The NbC gradually became “allotriomorphic” and was more uniformly distributed in the composites as the volume fraction increased from 1 vol%, 3 vol% to 5 vol%. High temperature friction wear tests showed that the wear rate of composites with NbC was lower than NbC-free ones. The wear rate of the composites with 5 vol% NbC increased from 2.51 × 10−8 mm3 N−1 ± 0.12 m-1 to 7.07 × 10−8 ±0.35 mm3 N−1m−1. While that of the NbC-free ones increased from 5.05 × 10−8 ± 0.25 mm3 N−1m−1 to 1.727 × 10−7 ± 0.86 mm3 N−1m−1 when the temperature was increased from 200 °C to 400 °C. The wear rate of the NbC-free samples was 1.727 × 10−7 ± 0.86 mm3 N−1m−1 at 400 °C, while that of samples with 5 vol% NbC was 7.07 × 10−8 ± 0.35 mm3 N−1m−1. Their wear mechanisms were oxidative wear, abrasive wear, and adhesive wear. This study provided ideas for work on the development of wear-resistant composites and promising applications in wear-resistant engineering products, such as shovel teeth and shield machine tool rings in mining and tunneling.