Despite evidence suggesting the utility of Epstein‐Barr virus (EBV) markers to stratify individuals with respect to nasopharyngeal carcinoma (NPC) risk in NPC high‐risk regions, no validated NPC risk ...prediction model exists. We aimed to validate an EBV‐based NPC risk score in an endemic population undergoing screening for NPC. This prospective study was embedded within an ongoing NPC screening trial in southern China initiated in 2008, with 51 235 adult participants. We assessed the score's discriminatory ability (area under the receiver‐operator‐characteristics curve, AUC). A new model incorporating the EBV score, sex and family history was developed using logistic regression and internally validated using cross‐validation. AUCs were compared. We also calculated absolute NPC risk combining the risk score with population incidence and competing mortality data. A total of 151 NPC cases were detected in 2008 to 2016. The EBV‐based score was highly discriminating, with AUC = 0.95 (95% CI = 0.93‐0.97). For 90% specificity, the score had 87.4% sensitivity (95% CI = 81.0‐92.3%). As specificity increased from 90% to 99%, the positive predictive value increased from 2.4% (95% CI = 1.9‐3.0%) to 12.5% (9.9‐15.5%). Correspondingly, the number of positive tests per detected NPC case decreased from 272 (95% CI = 255‐290) to 50 (41‐59). Combining the score with other risk factors (sex, first‐degree family history of NPC) did not improve AUC. Men aged 55 to 59 years with the highest risk profile had the highest 5‐year absolute NPC risk of 6.5%. We externally validated the discriminatory accuracy of a previously developed EBV score in a high‐risk population. Adding nonviral risk factors did not improve NPC prediction.
What's new?
Evidence suggests that markers of Epstein‐Barr virus (EBV) infection are useful in screening for nasopharyngeal carcinoma (NPC). Few prospective studies, however, have validated the performance of EBV‐based risk scores for NPC. In this prospective validation study with data for more than 51 000 participants, EBV‐based risk score based on the combination of IgA antibodies against viral capsid antigen and EBV nuclear antigen 1 was found to be highly discriminating for NPC over follow‐up periods lasting five years. The findings indicate that EBV‐based scores could be valuable risk‐prediction tools for early NPC diagnosis, leading to improved clinical outcomes.
Femoral nerve blocks (FNB) can provide effective pain relief but result in quadriceps weakness with increased risk of falls following total knee arthroplasty (TKA). Adductor canal block (ACB) is a ...relatively new alternative providing pure sensory blockade with minimal effect on quadriceps strength. The meta-analysis was designed to evaluate whether ACB exhibited better outcomes with respect to quadriceps strength, pain control, ambulation ability, and complications. PubMed, Embase, Web of Science, Wan Fang, China National Knowledge Internet (CNKI) and the Cochrane Database were searched for RCTs comparing ACB with FNB after TKAs. Of 309 citations identified by our search strategy, 12 RCTs met the inclusion criteria. Compared to FNB, quadriceps maximum voluntary isometric contraction (MVIC) was significantly higher for ACB, which was consistent with the results regarding quadriceps strength assessed with manual muscle strength scale. Moreover, ACB had significantly higher risk of falling versus FNB. At any follow-up time, ACB was not inferior to FNB regarding pain control or opioid consumption, and showed better range of motion in comparison with FNB. ACB is superior to the FNB regarding sparing of quadriceps strength and faster knee function recovery. It provides pain relief and opioid consumption comparable to FNB and is associated with decreased risk of falls.
BACKGROUND
The potential role of occupational exposures in the development of nasopharyngeal carcinoma (NPC) remains unclear, particularly in high‐incidence areas.
METHODS
The authors conducted a ...population‐based case‐control study, consisting of 2514 incident NPC cases and 2586 randomly selected population controls, in southern China from 2010 to 2014. Occupational history and other covariates were self‐reported using a questionnaire. Multivariate logistic regression was used to estimate odds ratios (ORs) with 95% confidence intervals (CIs) for the risk of NPC associated with occupational exposures. Restricted cubic splines were used to evaluate potentially nonlinear duration‐response relations.
RESULTS
Individuals who had exposure to occupational dusts (OR, 1.45; 95% CI, 1.26‐1.68), chemical vapors (OR, 1.37; 95% CI, 1.17‐1.61), exhausts/smokes (OR, 1.42; 95% CI, 1.25‐1.60), or acids/alkalis (OR, 1.56; 95% CI, 1.30‐1.89) in the workplace had an increased NPC risk compared with those who were unexposed. Risk estimates for all 4 categories of occupational exposures appeared to linearly increase with increasing duration. Within these categories, occupational exposure to 14 subtypes of agents conferred significantly higher risks of NPC, with ORs ranging from 1.30 to 2.29, including dust from metals, textiles, cement, or coal; vapor from formaldehyde, organic solvents, or dyes; exhaust or smoke from diesel, firewood, asphalt/tar, vehicles, or welding; and sulfuric acid, hydrochloric acid, nitric acid, and concentrated alkali/ammonia.
CONCLUSIONS
Occupational exposures to dusts, chemical vapors, exhausts/smokes, or acids/alkalis are associated with an excess risk of NPC. If the current results are causal, then the amelioration of workplace conditions might alleviate the burden of NPC in endemic areas.
LAY SUMMARY
The role of occupational exposures in the development of nasopharyngeal carcinoma (NPC) remains unclear, particularly in high‐incidence areas.
The authors conducted a population‐based study with 2514 incident NPC cases and 2586 population controls in southern China and observed that occupational exposures were associated with an increased risk of NPC.
Duration‐response trends were observed with increasing duration of exposure.
These findings provide new evidence supporting an etiologic role of occupational exposures for NPC in a high‐incidence region.
Occupational exposures are associated with an increased risk of nasopharyngeal carcinoma, and the association is primarily driven by 14 subtypes of occupational agents. Duration‐response trends are observed with increasing duration of exposure.
Metal‐organic frameworks (MOFs) have been widely studied as electrocatalysts, and the research strategy to improve their electrocatalytic oxygen evolution reaction (OER) performance is to modify ...their structure. In this paper, two‐dimensional bimetallic MOFs were constructed to improve electrocatalytic OER performance. Using a mild electrochemical method with Ni and Co as metal sources and 4, 4 ′‐biphenyl dicarboxylic acid (H2BPDC) as ligand, two‐dimensional NiCo‐BPDC was synthesized and then deposited on a carbon cloth electrode. The results show that NiCo‐BPDC/CC possessed a low overpotential of 356 mV at a current density of 20 mA cm−2 with a small Tafel slope of 86 mV dec−1 in 1.0 M KOH solution. The two‐dimensional NiCo‐BPDC exhibits excellent electrocatalytic OER performance because the coordination of Ni and Co in the material and the interaction of the two‐dimensional materials provide a large electrochemically active surface area and expose more metal active sites for OER, thus improving the reaction efficiency and indicating NiCo‐BPDC as potential OER electrocatalyst.
Key electrochemical synthesis: A key electrochemical synthesis method was employed to synthesize 2D NiCo‐BPDC MOFs material, which demonstrated simplicity, speed, and efficiency. This material was further utilized for electrocatalytic OER, showcasing the high‐efficiency oxygen evolution capability of its ultra‐thin nanosheet structure under electric action.
Neuroinflammation is an important component mechanism in the development of depression. Exosomal transfer of MDD-associated microRNAs (miRNAs) from neurons to microglia might exacerbate neuronal cell ...inflammatory injury.
By sequence identification, we found significantly higher miR-9-5p expression levels in serum exosomes from MDD patients than healthy control (HC) subjects. Then, in cultured cell model, we observed that BV2 microglial cells internalized PC12 neuron cell-derived exosomes while successfully transferring miR-9-5p. MiR-9-5p promoted M1 polarization in microglia and led to over releasing of proinflammatory cytokines, such as interleukin-1β (IL-1β), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), which exacerbated neurological damage. Furthermore, we identified suppressor of cytokine signaling 2 (SOCS2) as a direct target of miR-9-5p. Overexpression of miR-9-5p suppressed SOCS2 expression and reactivated SOCS2-repressed Janus kinase (JAK)/signal transducer and activator of transcription 3 (STAT3) pathways. Consistently, we confirmed that adeno-associated virus (AAV)-mediated overexpression of miR-9-5p polarized microglia toward the M1 phenotype and exacerbated depressive symptoms in chronic unpredictable mild stress (CUMS) mouse mode.
MiR-9-5p was transferred from neurons to microglia in an exosomal way, leading to M1 polarization of microglia and further neuronal injury. The expression and secretion of miR-9-5p might be novel therapeutic targets for MDD.
The American Heart Association recently released an updated algorithm for evaluating cardiovascular health (CVH)-Life's Essential 8 (LE8) score. Our objective was to investigate the correlation ...between levels of CVH, as determined by the LE8 score, and the risk of kidney stones among a representative sample of adults in the United States.
We included data from the National Health and Nutrition Examination Survey (NHANES) covering the years 2007–2016 for further analysis. The LE8 score, a comprehensive measurement ranging from 0 to 100, was used to evaluate overall CVH and classified into three categories: low (0–49), moderate (50–79), and high (80–100) CVH. Logistic regression was employed to assess the association between the LE8 score and kidney stones. Furthermore, sensitivity analysis was conducted to validate the findings, and the presence of a non-linear relationship was examined using restricted cubic spline (RCS) regression methods.
A total of 19,988 participants were included in this study (weighted mean age, 47.99 years; 95 % confidence interval CI: 47.46–48.53 years), with 10,319 being female (weighted percentage, 51.98 %; 95 % CI: 51.26–52.71 %) and 1923 identified as having kidney stones (weighted percentage, 9.95 %; 95 % CI: 9.41–10.53 %). In the fully-adjusted multivariable model, higher LE8 scores were associated with prevalence of self-reported kidney stones (odds ratio OR for a 10-unit increase in score, 0.86; 95 % CI: 0.82–0.91), presenting a linear dose-response relationship. Compared to the low CVH group, participants in the moderate and high CVH groups exhibited a lower prevalence of kidney stones (OR = 0.80; 95 % CI: 0.69–0.92; OR = 0.54; 95 % CI: 0.43–0.69, respectively). Similar trends were observed when assessing the association between health behavior scores and kidney stones. Moreover, the negative correlation between the LE8 score and the prevalence of kidney stones was markedly more pronounced in various stratified analyses.
Our study suggests that a higher level of CVH, as assessed by the LE8 metrics, is independently associated with a lower prevalence of self-reported kidney stones in a linear relationship. Further research, particularly through longitudinal or intervention studies, is required to establish whether actively promoting optimal CVH levels can effectively reduce the incidence of kidney stones.
•High LE8 cardiovascular health score is linked to reduced kidney stone prevalence.•Emphasizes cardiovascular health's role in medical discussions and preventive strategies.•LE8 score shows potential for enhancing kidney health, needing further research.
Background
An association between a nonmedicinal herbal diet and nasopharyngeal carcinoma (NPC) has often been hypothesized but never thoroughly investigated.
Methods
This study enrolled a total of ...2469 patients with incident NPC and 2559 population controls from parts of Guangdong and Guangxi Provinces in southern China between 2010 and 2014. Questionnaire information was collected on the intake of traditional herbal tea and herbal soup as well as the specific herbal plants used in soups and other potentially confounding lifestyle factors. Multivariate logistic regression models were used to estimate odds ratios (ORs) with 95% confidence intervals (CIs) for the NPC risk in association with herbal tea and soup intake.
Results
Ever consumption of herbal tea was not associated with NPC risk (OR, 1.03; 95% CI, 0.91‐1.17). An inverse association was observed for NPC among ever drinkers of herbal soup (OR, 0.78; 95% CI, 0.67‐0.90) but without any monotonic trend with an increasing frequency or duration of herbal soup consumption. Inverse associations with NPC risk were detected with 9 herbal plants used in herbal soup, including Ziziphus jujuba, Fructus lycii, Codonopsis pilosula, Astragalus membranaceus, Semen coicis, Smilax glabra, Phaseolus calcaratus, Morinda officinalis, and Atractylodes macrocephala (OR range, 0.31‐0.79).
Conclusions
Consuming herbal soups including specific plants, but not herbal tea, was inversely associated with NPC. If replicated, these results might provide potential for NPC prevention in endemic areas.
Consuming herbal soups is inversely associated with nasopharyngeal carcinoma in the endemic region of southern China. Nine herbal types are identified as responsible for this inverse association.
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