Long-term exposure to particulate matter and all-cause and cause-specific mortality in an analysis of multiple Asian cohorts.

BACKGROUND: Exposure to ambient air pollution is associated with a significant number of deaths. Much of the evidence associating air pollution with adverse effects is from North American and Europe, partially due to incomplete data in other regions limiting location specific examinations. The aim of the current paper is to leverage satellite derived air quality data to examine the relationship between ambient particulate matter and all-cause and cause-specific mortality in Asia. METHODS: Six cohorts from the Asia Cohort Consortium provided residential information for participants, recruited between 1991 and 2008, across six countries (Bangladesh, India, Iran, Japan, South Korea, and Taiwan). Ambient particulate material (PM2·5) levels for the year of enrolment (or 1998 if enrolled earlier) were assigned utilizing satellite and sensor-based maps. Cox proportional models were used to examine the association between ambient air pollution and all-cause and cause-specific mortality (all cancer, lung cancer, cardiovascular and lung disease). Models were additionally adjusted for urbanicity (representing urban and built characteristics) and stratified by smoking status in secondary analyses. Country-specific findings were pooled via random-effects meta-analysis. FINDINGS: More than 300,000 participants across six cohorts were included, representing more than 4-million-person years. A positive relationship was observed between a 5 µg/m (Dockery et al., 1993) increase in PM2·5 and cardiovascular mortality (HR: 1·06, 95 % CI: 0.99, 1·13). The additional adjustment for urbanicity resulted in increased associations between PM2.5 and mortality outcomes, including all-cause mortality (1·04, 95 % CI: 0·97, 1·11). Results were generally similar regardless of whether one was a current, never, or ex-smoker. INTERPRETATION: Using satellite and remote sensing technology we showed that associations between PM2.5 and all-cause and cause-specific Hazard Ratios estimated are similar to those reported for U.S. and European cohorts. FUNDING: This project was supported by the Health Effects Institute. Grant number #4963-RFA/18-5. Specific funding support for individual cohorts is described in the Acknowledgements.

Origin of giant enhancement of phase contrast in electron holography of modulation-doped n-type GaN.

The electron optical phase contrast probed by electron holography at n-n+ GaN doping steps is found to exhibit a giant enhancement, in sharp contrast to the always smaller than expected phase contrast reported for p-n junctions. We unravel the physical origin of the giant enhancement by combining off-axis electron holography data with self-consistent electrostatic potential calculations. The predominant contribution to the phase contrast is shown to arise from the doping dependent screening length of the surface Fermi-level pinning, which is induced by FIB-implanted carbon point defects below the outer amorphous shell. The contribution of the built-in potential is negligible for modulation doping and only relevant for large built-in potentials at e.g. p-n junctions. This work provides a quantitative approach to so-called dead layers at TEM lamellas.

[Association of waist-to-height ratio with sarcopenic obesity in hemodialysis patients with normal body mass index].

Objective: To explore the association between waist-to-height ratio (WHtR) and sarcopenic obesity (SO) in maintenance hemodialysis (MHD) patients with normal body mass index (BMI). Methods: A multicenter and cross-sectional study that included adult patients undergoing MHD was conducted in 20 hemodialysis centers from June 1st to August 30th, 2021. Body composition was evaluated by body composition monitor based on bioimpedance spectroscopy. According to the quartiles of WHtR, patients were divided into four groups: Q1, Q2, Q3 and Q4 group. The association of WHtR with SO was determined by multiple logistic regression models, stratified analyses, interactive analyses, and receiver operating characteristic (ROC) analyses, respectively. Results: A total of 2 207 MHD patients (1 341 males and 866 females) were included, and aged [M (Q1, Q3)] 57 (44, 68) years. The prevalence of SO was increased with increasing quartiles of WHtR [8.6% (46/533), 22.5% (141/628), 35.4% (215/608), and 44.3% (194/438) for Q1, Q2, Q3, and Q4 group, respectively]. Multivariate logistic regression analysis showed that WHtR was associated with SO. The association remained statistically significant even after adjusting for age, gender, dialysis vintage, BMI, biochemical indicators, and various medical histories. Compared with Q1 group, the odds ratios (OR) were 2.54 (95%CI: 1.69-3.83), 4.30 (95%CI: 2.88-6.42) and 5.18 (95%CI: 3.37-7.96) for Q2, Q3 and Q4 group, respectively. The interaction analysis showed that age, sex and history of diabetes had interactive roles in the association between WHtR and SO (all P<0.05). The association stably existed across subgroups, and it was more obvious in male patients, those with older age and without a history of diabetes（all P<0.05）. Furthermore, the cut-off value of WHtR identifying SO in male patients was 0.49, and the corresponding area under the curve (AUC) was 0.73 (95%CI: 0.70-0.75), with the sensitivity of 72.7% and specificity of 60.3%. In female patients, the cut-off value was 0.51, and the AUC was 0.68 (95%CI: 0.65-0.71), with the sensitivity of 70.1% and specificity of 57.8%. Conclusion: WHtR could be used as a simple index to evaluate the risk of SO in MHD patients with normal BMI.

Neurological complications of COVID-19.

Corona Virus Disease 2019 (COVID-19) has caused several pandemic peaks worldwide due to its high variability and infectiousness, and COVID-19 has become a long-standing global public health problem. There is growing evidence that severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) frequently causes multi-organ injuries and more severe neurological manifestations. Therefore, increased awareness of possible neurological complications is beneficial in preventing and mitigating the impact of long-term sequelae and improving the prognostic outcome of critically ill patients with COVID-19. Here, we review the main pathways of SARS-CoV-2 neuroinvasion and the potential mechanisms causing neurological damage. We also discuss in detail neurological complications, aiming to provide cutting-edge basis for subsequent related basic research and clinical studies of diagnosis and treatment.

Impact of COVID-19 on the sleep-wake patterns of preschool children.

OBJECTIVE: To explore the impact of the COVID-19 pandemic on the sleep-wake patterns of preschool children. METHODS: A cohort of preschoolers established before the COVID-19 pandemic was invited to participate in this study. Data including children's demographics, their own and parental sleep-wake patterns, physical activities, and screen time were collected through an online questionnaire from August to September 2020. A comparison was made on the collected data from the same cohort of children before and during the pandemic. RESULTS: The cohort which was established before the pandemic consisted of 3720 preschoolers. For this current study, 642 (17%) participated, and 497 (13%) children who fulfilled the eligibility criteria were included in the final analysis. They showed a delay in their bedtime and wake time on both weekdays and weekends with a 15-30 min increase in nocturnal sleep duration. However, with a reduction in nap time, the average daily sleep duration was shortened by 16.3 ± 64.3 min (p < 0.001) and 27.5 ± 72.9 min (p < 0.001) during weekdays and weekends, respectively. Screen time was increased while outdoor activity duration was decreased. Parental sleep/wake times were also delayed with an increase in sleep duration. Children's sleep habits were associated with screen time and parental sleep/wake patterns. CONCLUSION: Despite school suspension during the COVID-19 pandemic, preschoolers were not sleeping longer. Screen time and parental sleep/wake patterns were the major factors driving the preschoolers' sleep habits. Health education is required to control screen time in children and to promote sleep hygiene among all family members.

[A two-stitch continuous suture method for single-lumen ileostomy].

Objective: To explore the value of a two-stitch continuous suture in single- lumen ileostomy. Methods: This was a retrospective cohort study. Data for 98 patients who underwent single-lumen enterostomy were retrospectively collected between 1 January 2021 and 1 May 2022 at Zhujiang Hospital of Southern Medical University. All patients met the indications for prophylactic single-lumen ileostomy. Those older than 80 years of age, with complex underlying diseases, extremely poor systemic conditions who could not tolerate surgery, poor blood supply at the end of the bowel, and severe edema or severe infection at the end of the bowel were excluded. Among the included patients, patients who underwent surgery before 1 October 2021 underwent ileostomy with interrupted suture (control group, n=60), and patients operated on and after 1 October 2021 routinely underwent two-stitch continuous suture ileostomy (two-stitch stoma group, n=38). Two-stitch continuous suture ileostomy is performed as follows: the first continuous suture is used to suture the intestinal seromuscular layer, peritoneum, posterior sheath, and anterior sheath from deep to superficial layers. The bowel wall is then opened. The second continuous suture is used to suture the full thickness of the bowel and the skin. The differences in postoperative ostomy-related complications and operation time were compared between the groups. Results: There were no significant differences in baseline data between the groups (all, P>0.05). The operative time in the two-stitch stoma group was shorter than that of the control group (16.6±2.2 minutes vs. 25.1±2.4 minutes, respectively; t=-17.874;P<0.001). The incidences of mucocutaneous separation, dermatitis, and stoma rebound in the two-stitch stoma group were lower than those of the control group [5.3% (2/38) vs. 31.7% (19/60), χ2=9.633, P=0.002;5.3% (2/38) vs. 28.3% (17/60), χ2=7.923, P=0.005; and 2.6% (1/38) vs. 18.3% (11/60), P=0.026, respectively], while the incidences of parastomal hernia and stoma prolapse, and the postoperative visual analog scale scores in the two groups were similar (all P>0.05). Conclusion: Compared with traditional single-lumen ileostomy, two-stitch continuous suture ileostomy has the advantages of short operation time, simplicity, esthetic appearance of the stoma, and a significant reduction in the postoperative complications associated with ileostomy.

Adolescent and parent perspectives on genomic sequencing to inform cancer care.

Next-generation sequencing offers opportunities for targeted cancer therapies and may identify pathogenic germline variants. Adolescents' perception of testing is not well understood. We surveyed 16 adolescents and 59 parents regarding motivations, attitudes, and knowledge related to paired tumor/germline sequencing. Participants generally had a good objective understanding of germline genetics and cancer risk, with parents scoring higher than adolescents. Nearly all participants were motivated by a desire to help other patients and to treat their child/themselves. Most adolescents reported involvement in the decision to enroll in the study. Study findings suggest important similarities and differences between parent and adolescent views.

[A study on longitudinal changes in white matter microstructure of parents who have lost their only child based on diffusion tensor imaging and its relationship with symptoms of posttraumatic stress disorder].

Objective: To investigate the longitudinal changes of white matter microstructural based on diffusion tensor imaging in parents who lost their only child without psychiatric disorders and its relationship with symptoms of posttraumatic stress disorder (PTSD). Methods: Parents who had who lost their only child and without psychiatric disorders in Jiangsu Province, from September 2016 to March 2017, were retrospectively collected (TENP group, 32). MRI scans were performed at baseline and at the end of 5-year follow-up, and the Clinician Administered PTSD Scales (CAPS) were used for assessing the severity of symptoms. Additionally, sex, age and education level matched healthy subjects were recruited as healthy controls (control group, 27) and underwent MRI scanning using the same protocol. The differences of fractional anisotropy (FA) values between TENP group and control group at baseline were analyzed by using Tract-based spatial statistics method, and the brain areas of lateral differences were used as the regions of interest for longitudinal follow-up analysis of TENP group. Partial correlation analysis was used to evaluate the relationship between FA values changes in longitudinal differences in brain regions and CAPS scores. Results: Compared with the control group, FA values of the right cingulate gyrus, Uncinate fasciculus, superior longitudinal fasciculus, corticospinal tract, Inferior fronto-occipital fasciculus, Inferior longitudinal fasciculus and forceps major in TENP group were decreased at baseline ((0.613±0.032) vs (0.631±0.034), (0.539±0.048) vs (0.563±0.045), (0.534±0.033) vs (0.558±0.039), (0.560±0.038) vs (0.580±0.030), (0.519±0.023) vs(0.549±0.024), (0.489±0.038) vs (0.518±0.027), (0.499±0.027) vs (0.533±0.032); all P<0.05). From baseline to follow-up, scores of trauma reexperience symptoms and avoidance/numbness symptoms were decreased ((5.2±2.8) vs (8.1±4.9), (4.0±3.2) vs (6.6±5.4); all P<0.05); FA values of the right corticospinal tract, Inferior fronto-occipital fasciculus, Inferior longitudinal fasciculus and forceps major were decreased ((0.523±0.049) vs (0.537±0.049), (0.568±0.052) vs (0.590±0.050), (0.540±0.063) vs (0.559±0.059), (0.520±0.059) vs (0.547±0.059); all P<0.05); The decrease of FA values of the right Inferior fronto-occipital fasciculus and right Inferior longitudinal fasciculus was negatively correlated with the decrease of avoidance/numbness symptoms scores (r=-0.458, -0.374, respectively, all P<0.05). Conclusions: The trauma of parents who lost their only child can result in impaired microstructural integrity of white matter. As the post-traumatic time goes by, parents who have lost their only child do not develop to PTSD and other psychiatric disorders, and the clinical symptoms are alleviated, the damage of the white matter microstructure continued to progress.

Effect of copper on the photosynthesis and growth of Eichhornia crassipes.

Although copper is essential for plant growth and development and plays an important role in many physiological processes, excess copper, resulting from industrial development and population expansion in the recent decades, leads to environmental pollution and has been a cause of wide concern for the adverse effects on photosynthesis, metabolism and growth of plants. The growth properties (e.g. fresh weight, root length, height), photosynthetic properties (e.g. gas exchange, chlorophyll a fluorescence, chlorophyll content) and the physiological index (e.g. activity of antioxidant enzymes and osmotic regulators) of Eichhornia crassipes were assessed under various Cu2+ concentrations in hydroponic experiments. The growth of E. crassipes was negatively affected by Cu2+ treatments, especially at higher Cu2+ concentrations; the Cu2+ treatments resulted in decreased photosynthesis because of a decrease in leaf chlorophyll content and damage to PSII functions, except the oxygen-evolving complex. The physiological tolerance of E. crassipes to Cu2+ relies on osmotic regulation, anti-lipid peroxidation and improved antioxidant properties. The results indicate that E. crassipes could be considered as a phytoremediation agent for Cu2+ pollution in aquatic environments. However, the benefit of E. crassipes for Cu2+ removal in a highly polluted aquatic environment will be limited, but it will be effective in remediating sites with low pollution (≤5 mg·l-1 ). The present results could provide not only a basis for understanding the effects of pollutants on photosynthesis in plants under heavy metal stress but also provide a basis for choosing plants for phytoremediation.

[Application of clip remodeling technique in microsurgical treatment of intracranial aneurysms via keyhole approaches].

Objective: To discuss the value and technique of clip remodeling in microsurgical treatment of intracranial aneurysms via keyhole approaches. Methods: The clinical data of patients with intracranial aneurysms, who were treated by microsurgical clipping via keyhole approaches from January 2017 to December 2019, were retrospectively analyzed. The clips were remodeled based on the aneurysmal characteristics during the procedure in 27 cases. Angiography was obtained within one week after surgery in order to evaluate the position of clips and the security of lesions. All patients were followed up at the outpatient clinic to assess the clinical outcomes. Results: A total of 27 patients harbored 30 intracranial aneurysms, including 23 ruptured lesions and 7 unruptured ones. There were 9 middle cerebral artery aneurysms, 11 anterior communicating artery aneurysms, 9 posterior communicating artery aneurysms and 1 anterior cerebral artery aneurysm, respectively. Nine patients were operated via supraorbital keyhole approach, as well as 17 via pterional keyhole approach and one via hemispheric keyhole approach. Postoperative angiography revealed complete obliteration of lesions without residual filling in all cases. Twenty-five patients recovered well at discharge and two presented with mild disability. After 3-36 months of follow-up, no rebleeding and new-onset neurological deficits were noted. Conclusion: Clip remodeling technique is a simple and effective option, which can alleviate the limitation of manipulative freedom under keyhole approaches and improve the microsurgical effect of intracranial aneurysms.

[A special on epidemic prevention and control:screening for novel coronavirus related conjunctivitis among the patients with coronavirus disease 2019].

This article was published ahead of print on the official website of Chinese Journal of Ophthalmology on April 16,2020. Objective: To screen for novel coronavirus related conjunctivitis among patients with coronavirus disease 2019. Methods: Prospective series case study. Eighty-one patients diagnosed as coronavirus disease 2019 in Guangxi Zhuang Autonomous Region People's Hospital were enrolled with ophthalmological consultation and screening for novel coronavirus related conjunctivitis, including the inquiring of eye symptoms and checking for conjunctivitis-related signs. Novel coronavirus nucleic acid testing of conjunctival swabs was performed on patients with clinical manifestations of conjunctivitis. Results: Only 3 of the 81 patients (3.70%) complained of eye discomfort, which appeared on day 16.67±9.29 after the diagnosis of coronavirus disease 2019. The eye signs were not typical of viral conjunctivitis. Novel coronavirus nucleic acid tests of conjunctival swabs were negative in both eyes. There was no evidence to support the diagnosis of novel coronavirus related conjunctivitis. The remaining 78 patients showed no clinical symptoms or signs of conjunctivitis. Conclusions: The occurrence of novel coronavirus related conjunctivitis may be low in patients with coronavirus disease 2019.(Chin J Ophthalmol, 2020, 56: 433-437).

New Opportunities and Challenges for Forensic Medicine in the Era of Artificial Intelligence Technology.

ABSTRACT: Traditional forensic identification relies on forensic experts to manually extract information and provide identification opinions based on medicine, biology and other fields of knowledge combined with personal work experience, which is not only time-consuming and require great effort, but also affected by subjective factors that are difficult to overcome. In the era of big data, the booming development of artificial intelligence brings new ideas to forensic medicine. In recent years, forensic researchers at home and abroad have conducted many studies based on artificial intelligence technology, such as face recognition, age and gender identification, DNA analysis, postmortem interval estimation, injury and cause of death identification, showing the feasibility and advantages of using artificial intelligence technology to solve forensic identification problems. As a new means of technology that has adapted to the development of the times, artificial intelligence has brought new vitality to forensic medicine, but at the same time also some new challenges. How to deal with these challenges scientifically and form a new mode of 'artificial intelligence plus forensic medicine' with artificial intelligence and forensic medicine developing collaboratively is a new direction for the development of forensic medicine in the era of big data.

Disclosing genetic risk for Alzheimer's dementia to individuals with mild cognitive impairment.

INTRODUCTION: The safety of predicting conversion from mild cognitive impairment (MCI) to Alzheimer's disease (AD) dementia using apolipoprotein E (APOE) genotyping is unknown. METHODS: We randomized 114 individuals with MCI to receive estimates of 3-year risk of conversion to AD dementia informed by APOE genotyping (disclosure arm) or not (non-disclosure arm) in a non-inferiority clinical trial. Primary outcomes were anxiety and depression scores. Secondary outcomes included other psychological measures. RESULTS: Upper confidence limits for randomization arm differences were 2.3 on the State Trait Anxiety Index and 0.5 on the Geriatric Depression Scale, below non-inferiority margins of 3.3 and 1.0. Moreover, mean scores were lower in the disclosure arm than non-disclosure arm for test-related positive impact (difference: -1.9, indicating more positive feelings) and AD concern (difference: -0.3). DISCUSSION: Providing genetic information to individuals with MCI about imminent risk for AD does not increase risks of anxiety or depression and may provide psychological benefits.

Transcriptomic changes in the nasal epithelium associated with diesel engine exhaust exposure.

BACKGROUND: Diesel engine exhaust (DEE) exposure causes lung cancer, but the molecular mechanisms by which this occurs are not well understood. OBJECTIVES: To assess transcriptomic alterations in nasal epithelium of DEE-exposed factory workers to better understand the cellular and molecular effects of DEE. METHODS: Nasal epithelial brushings were obtained from 41 diesel engine factory workers exposed to relatively high levels of DEE (17.2-105.4 µg/m3), and 38 unexposed workers from factories without DEE exposure. mRNA was profiled for gene expression using Affymetrix microarrays. Linear modeling was used to identify differentially expressed genes associated with DEE exposure and interaction effects with current smoking status. Pathway enrichment among differentially expressed genes was assessed using EnrichR. Gene Set Enrichment Analysis (GSEA) was used to compare gene expression patterns between datasets. RESULTS: 225 genes had expression associated with DEE exposure after adjusting for smoking status (FDR q < 0.25) and were enriched for genes in pathways related to oxidative stress response, cell cycle pathways such as MAPK/ERK, protein modification, and transmembrane transport. Genes up-regulated in DEE-exposed individuals were enriched among the genes most up-regulated by cigarette smoking in a previously reported bronchial airway smoking dataset. We also found that the DEE signature was enriched among the genes most altered in two previous studies of the effects of acute DEE on PBMC gene expression. An exposure-response relationship was demonstrated between air levels of elemental carbon and the first principal component of the DEE signature. CONCLUSIONS: A gene expression signature was identified for workers occupationally exposed to DEE that was altered in an exposure-dependent manner and had some overlap with the effects of smoking and the effects of acute DEE exposure. This is the first study of gene expression in nasal epithelial cells of workers heavily exposed to DEE and provides new insights into the molecular alterations that occur with DEE exposure.

DNA Molecular Identification of Human Phenotypic Characteristics--New Progress Over the Past Five Years.

ABSTRACT: Molecular identification of human externally visible characteristic （EVC）, which is also called forensic DNA phenotyping （FDP）, can serve as a "molecular witness" when the routine investigations can not determine the identity of a criminal and the DNA database find no match after comparison. FDP could assist in investigation of cases by inferring the externally visible phenotypic characteristics from DNA obtained from the biological materials left at crime scenes, or unknown corpses. In the last few years, studies on the selection of EVC related molecular markers have been reported frequently and some of the EVCs could already be inferred with a certain accuracy, such as hair color and iris color. Further fundamental research on molecular genetics of human external phenotypic characteristics, as well as the continuous innovation on molecular biological technology would promote the rapid development of DNA molecular identification of human phenotypic characteristics.

Detection of Ancestry Information of Urumqi Mongolians Based on the AIM-InDels Loci Multiplex System.

ABSTRACT: Objective To explore the genetic background and structure of Urumqi Mongolians, the previously developed 39-AIM-InDels panel for ancestry inference was utilized in the present study. Methods The blood samples of 145 unrelated healthy Urumqi Mongolian individuals were collected and genotyped. The compositions of ancestry information of Urumqi Mongolians were studied with 17 different populations from three continents （East Asia, Europe and Africa） as reference populations. Then, multiple population genetics and bioinformatics analysis methods were applied, the Fst and DA values between matched populations were compared and analyzed, PCA analysis was performed and a phylogenetic tree was constructed. The proportions of ancestry information components of Urumqi Mongolians were analyzed with Structure software, etc. Results The ancestry information components of Urumqi Mongolian group in different intercontinental populations accounted for 89%, 7%, and 3% of East Asian, European, and African populations, respectively. Compared with other intercontinental populations, Urumqi Mongolian group and East Asian populations have lower Fst and DA values, and they were in the same cluster in PCA analysis as well. In a phylogenetic tree, the Urumqi Mongolian group was in the same branch as East Asian populations. Conclusion Urumqi Mongolian group had relatively close genetic relationships with East Asian populations, and the proportion of its East Asian ancestry was about 89%.

[Establishment of rat model of cardiorenal syndrome by transabdominal subtotal nephrectomy].

Objective: To evaluate the changes of rat renal function and cardiac function after transabdominal subtotal nephrectomy (STNx) and provide an ideal animal model for the study of chronic kidney disease (CKD) and cardiorenal syndrome (CRS). Methods: The SD rats (male, 5-6 weeks) were randomly divided into Sham group (n=10) and STNx group (n=10). The rats from Sham group underwent sham surgery, and the right nephrectomy plus the 2/3 left kidney artery ligation through abdominal incision were performed in the rats from STNx group. Twelve weeks after operation, the rat serum creatinine and renal pathology were examined, the size and fibrosis of cardiac cells were also observed, after the changes of cardiac function being detected by echocardiography. Results: Twelve weeks after the operation, STNx group rats were generally in poor condition, with a emaciated body, absorption of the renal infarct tissue, uneven surface, and residual renal tissue compensatory hypertrophy. The serum creatinine in Sham group and STNx group was (22.10±1.64) µmol/L and (52.80±3.34) µmol/L, respectively, and there was a statistically significant difference between the two groups (P<0.001). Compared with Sham group, the echocardiography results demonstrated that the thickness of left ventricular wall of rats from STNx group increased, the left ventricular volume decreased, and the diastolic and systolic function of left ventricular descended. The HE staining showed that the glomerulus, tubules and interstitial renal morphology were normal in Sham group, and glomerular sclerosis was observed in STNx group. And the Masson staining declared that the renal fibrous tissue distribution was normal in Sham group, and severe renal interstitial fibrosis was observed in STNx group. The wheat germ agglutinin (WGA) staining of myocardial tissue showed that myocardial cells in STNx group were larger than those in Sham group (1.293±0.060 vs 1.000±0.059, P<0.001). Moreover, the HE staining showed that there was partial myocardial tissue necrosis and fibrosis in STNx group, and severe myocardial fibrosis was observed in STNx group by Masson staining. Conclusion: Similar pathophysiological changes in human CKD were observed in the rats CKD model by transabdominal STNx, and the cardiac effects of this model make it an ideal choice to study CRS.

Next-generation sequencing in precision oncology: Patient understanding and expectations.

BACKGROUND: Implementation of precision oncology interventions poses several challenges to informed consent and patient education. This study assessed cancer patients' understanding, expectations, and outcomes regarding participation in research examining the impact of matched tumor and germline sequencing on their clinical care. METHODS: A total of 297 patients (mean age: 59 years; 50% female; 96% white) with refractory, metastatic cancer were surveyed, including 217 who completed surveys both before and after undergoing integrated whole exome and transcriptome sequencing as part of a larger clinical research study. RESULTS: At baseline, the vast majority of patients expected to receive several potential direct benefits from study participation, including written reports of sequencing findings (88%), greater understanding of the causes of their cancer (74%), and participation in clinical trials for which sequencing results would make them eligible (84%). In most cases, these benefits were not realized by study completion. Despite explanations from study personnel to the contrary, most participants (67%-76%) presumed that incidental germline sequencing findings relevant to noncancerous health conditions (eg, diabetes) would automatically be disclosed to them. Patients reported low levels of concern about study risks at baseline and low levels of regret about study participation at follow-up. CONCLUSIONS: Findings suggest that cancer patients participating in precision oncology intervention research have largely unfulfilled expectations of direct benefits related to their study participation. Increased focus on patient education to supplement the informed consent process may help manage patients' expectations regarding the extent and likelihood of benefits received as a result of undergoing genomic sequencing.

Long non-coding RNA AFAP1-AS1 accelerates invasion and predicts poor prognosis of glioma.

OBJECTIVE: The role of AFAP1-AS1 in glioma is not fully known. This study aims at investigating the expression of AFAP1-AS1 in glioma and its underlying mechanism. PATIENTS AND METHODS: AFAP1-AS1 expressions in brain tissues from 52 cases of glioma and 5 cases of traumatic brain injury were assessed using quantitative fluorescence polymerase chain reaction (PCR). The clinicopathological features of glioma were first recorded. The correlation between AFAP1-AS1 expression and prognosis of glioma was discussed. AFAP1-AS1 expressions in the glioma cell lines were further detected. After knockdown of AFAP1-AS1 in U87MG and U251 glioma cells, cell invasion was assessed by transwell assay. MMP2 and MMP9 expressions in glioma cells, which were important indicators of cell invasive-ness, were determined by Western blot. RESULTS: AFAP1-AS1 was upregulated in the glioma tissues compared with that in the control tissues, and the expression level was correlated with glioma grading and KPS scores. After knockdown of AFAP1-AS1, the invasion capacities of the glioma cells declined significantly, and the expressions of invasion-related proteins MMP2 and MMP9 also decreased significantly. CONCLUSIONS: lncRNA AFAP1-AS1 can considerably facilitate the invasion of glioma cells and acts as an independent predictor of malignancy and prognosis, which may also serve as a potential therapeutic target.

Oncologists' Use of Genomic Sequencing Data to Inform Clinical Management.

PURPOSE: To determine whether oncologists intended to change treatment as a result of tumor sequencing, and subsequently, whether patients experienced an alteration of clinical management or derived clinical benefit. PATIENTS AND METHODS: A prospective survey of oncologists referring adult patients with rare, advanced, or refractory cancer to the Michigan Oncology Sequencing program was conducted from June 2014 to March 2015 to assess the use of and intent to disclose sequencing findings. Oncologists' responses were compared with the referred patients' self-reported survey responses, and a content analysis of disclosure documented in the medical record was performed. Medical records were reviewed retrospectively to determine if clinical management was informed or changed by sequencing results. RESULTS: Oncologists (response rate, 93%) referring 112 consecutive patients were surveyed. Medical records of patients were reviewed for changes in clinical management on the basis of sequencing findings. Oncologists intended to change the treatment of 22% of patients (n = 24) on the basis of sequencing findings. Of these patients, 37.5% (n = 9) had an actual change in clinical management. Thirty-four patients with postsequencing survey data reported that a results disclosure discussion did not occur, despite documentation of disclosure by the physician in the medical record. CONCLUSIONS: Findings demonstrate that many oncologists view next-generation sequencing results to be potentially valuable in directing subsequent therapy for their patients; however, barriers in communicating results to patients and implementing them in clinical management remain.