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Background The HER2 immunohistochemistry (IHC) test is an essential method for detecting breast cancer (BC) and plays a pivotal role in guiding personalized treatment strategies. However, inconsistencies persist among different pathologists using IHC, especially for HER2-low and HER2-negative. This may lead to discrepant clinical decisions, potentially impacting patient outcomes. Since HER2 exists in both dimeric and monomeric forms in cells, certain binding sites of diagnostic antibodies on HER2 dimers may be partially obscured in detection. Therefore, accurately detecting HER2 dimers in IHC is crucial for improving diagnostic precision. Methods We aligned the structures of HER2 heterodimers and Fabs of pertuzumab and trastuzumab binding to HER2, and found they binding in the same region. To overcome the steric hindrance of HER2 dimers, we employed HER2-binding affibody (Aby) and nanobody (Nby) to construct their fusion protein (Nby-Aby) and human heavy chain ferritin (HFn) based nanoparticles (Nby-HFn, Aby-HFn) for detection. Since the Nby and Aby bind HER2 at two distinct regions that are separate from the HER2 dimerization region, effectively minimizing interference from HER2 dimerization in detection. We assessed the detection performance of Nby-Aby in BC tissues and compared it with conventional HER2 diagnostic antibodies using tissue microarrays (TMAs). Results The Nby-Aby assay had higher detection sensitivity for HER2-positive cells in BC tissues compared to the conventional method. Additionally, significantly higher HER2 scores were observed in most BC tissues on tissue microarrays (TMAs) compared to those diagnosed using the traditional method. These findings suggest that dual-targeting and overcoming steric hindrance in HER2 IHC detection is a promising strategy to enhance diagnostic precision. Conclusions Dual-targeting different regions and overcoming steric hindrance of HER2 in IHC detection through the Nby-Aby fusion protein enhances diagnostic sensitivity, providing a novel strategy for more accurate HER2 IHC assessment in BC diagnosis.

This study proposes ConditionCDVAE+, a crystal diffusion variational autoencoder (CDVAE) based deep generative model for inverse design of van der Waals (vdW) heterostructures. To address the challenges of traditional experimental methods relying on trial-and-error and existing models struggling to incorporate target property constraints, this work achieves breakthroughs through three innovative stages: (1) introduce the SE(3)-equivariant graph neural network EquiformerV2 as the encoder-decoder within the CDVAE framework to enhance the generation quality of the model; (2) design a module integrating Low-rank Multimodal Fusion and Generative Adversarial Networks to map properties and structures into a joint latent space; and (3) for the first time propose a generative model for the vdW heterostructures, by conducting experimental validation on the dataset constructed from Janus III–VI vdW heterostructures. Experiments demonstrate that ConditionCDVAE+ achieves optimal root mean square error for crystal reconstruction, with improved generation quality. Density Functional Theory calculations confirms 99.51% of generated samples converge to energy minima, indicating superior ground-state convergence. The effectiveness of the model under conditional guidance has also been extensively validated. This framework provides an efficient solution for target-oriented design of vdW heterostructures and holds promise for accelerating the development of novel optoelectronic devices.

Background Nanoplastics (NPs) are now a new class of pollutants widely present in the soil, atmosphere, freshwater and marine environments. Nanoplastics can rapidly penetrate cell membranes and accumulate in human tissues and organs, thus posing a potential threat to human health. The heart is the main power source of the body. But up to now, the toxicological effects of long-term exposure to nanoplastics on the heart has not been revealed yet. Results We evaluated the effects of long term exposure of nanoplastics on cardiac cell/tissue in vitro and in vivo model. Furthermore, we explored the molecular mechanism by which nanoplastics exposure causes myocardial cell senescence. Immunohistochemistry, indirect immunofluorescence and ELISA were performed to detect the effects of nanoplastics on heart aging. We found that nanoplastics were able to induce significant cardiac aging through a series of biochemical assays in vivo. In vitro, the effects of nanoplastics on cardiac cell were investigated, and found that nanoplastics were able to internalize into cardiomyocytes in time and dose-dependant manner. Further biochemical analysis showed that nanoplastics induces cardiomyocytes senescence by detecting a series of senescence marker molecules. Molecular mechanism research shows that nanoplastics may cause mitochondrial destabilization by inducing oxidative stress, which leads to the leakage of mtDNA from mitochondria into the cytoplasm, and then cytoplasm-localized mt-DNA activates the cGAS-STING signaling pathway and promotes inflammation response, ultimately inducing cardiomyocytes senescence. Conclusions In this work, we found that nanoplastics exposure induces premature aging of heart. Current research also reveals the molecular mechanism by which nanoplastics induces cardiomyocyte senescence. This study laid the foundation for further studying the potential harm of nanoplastics exposure on heart. Graphical abstract

Background: The most common loadable chemotherapeutic drugs in drug-eluting bead transarterial chemoembolization (DEB-TACE) include doxorubicin, epirubicin, etc. CalliSpheres® beads have exhibited efficient loadability and eluting characteristics for raltitrexed as well as in vitro and animal experiments. However, the efficacy and safety of raltitrexed-loaded DEB-TACE in patients with intermediate-stage hepatocellular carcinoma (HCC) remain unclear. Objectives: To assess the efficacy and safety of raltitrexed-loaded DEB-TACE in patients with intermediate-stage HCC. Design: The study was conducted as a single-arm prospective study. Methods: This study was a prospective, single-arm trial conducted between June 2019 and June 2022. CalliSpheres® beads loaded with raltitrexed were used in the DEB-TACE procedure. The follow-up lasted for at least 1 year or until death. The primary endpoint was overall survival (OS), and the secondary endpoints were time to progression (TTP), progression-free survival (PFS), objective response rate (ORR), and adverse events (AEs). Results: The 6-month ORR and disease control rates were 90.1% and 93.8%, respectively. The median OS was 33.0 months. The 1-, 2-, and 3-year survival rates were 95.1%, 82.1%, and 43.6%, respectively. Child–Pugh class and bilobar disease occurrence were identified as independent OS predictors. The median TTP and PFS were 22.7 and 19.8 months, respectively. Eleven (11.5%) patients experienced at least one grade 3 AE, and serious AEs were reported in five participants (5.2%). No patient experienced grade 4 or 5 AEs. Conclusion: Raltitrexed-loaded DEB-TACE is feasible, safe, and effective in patients with intermediate-stage HCC. Trial registration: This trial was registered at www.chictr.org.cn under the identifier: 1900024097 on 25 June 2019. Plain language summary Efficacy and safety of raltitrexed-loaded DEB-TACE in patients with intermediate-stage hepatocellular carcinoma The utility of raltitrexed-loaded CalliSphere® beads in drug-eluting bead transarterial chemoembolization (DEB-TACE) has been demonstrated in in vitro and animal experiments. However, its efficacy and safety in patients with intermediate-stage hepatocellular carcinoma (HCC) remain unclear. Hence, this study aimed to assess the efficacy and safety profiles of DEB-TACE for such patients. We discovered that raltitrexed-loaded DEB-TACE led to a 6-month ORR of 90.1%, a median OS of 33.0 months, a median TTP of 22.7 months, and a median PFS of 19.8 months. The 1-, 2-, and 3-year survival rates were 95.1%, 82.1%, and 43.6%, respectively. Factors such as Child-Pugh class and bilobar disease occurrence were identified as independent predictors of OS. The study also showed acceptable safety profiles, with a low incidence of grade 3 adverse events and no grade 4 or 5 adverse events. The results indicated that raltitrexed-eluting CalliSpheres® beads for TACE can be a viable option for treating patients with intermediate-stage HCC.

Sulfitobacter is one of the major sulfite-oxidizing alphaproteobacterial groups and is often associated with marine algae and corals. Their association with the eukaryotic host cell may have important ecological contexts due to their complex lifestyle and metabolism. However, the role of Sulfitobacter in cold-water corals remains largely unexplored. In this study, we explored the metabolism and mobile genetic elements (MGEs) in two closely related Sulfitobacter faviae strains isolated from cold-water black corals at a depth of ~1000 m by comparative genomic analysis. The two strains shared high sequence similarity in chromosomes, including two megaplasmids and two prophages, while both contained several distinct MGEs, including prophages and megaplasmids. Additionally, several toxin-antitoxin systems and other types of antiphage elements were also identified in both strains, potentially helping Sulfitobacter faviae overcome the threat of diverse lytic phages. Furthermore, the two strains shared similar secondary metabolite biosynthetic gene clusters and genes involved in dimethylsulfoniopropionate (DMSP) degradation pathways. Our results provide insight into the adaptive strategy of Sulfitobacter strains to thrive in ecological niches such as cold-water corals at the genomic level.

The filamentous ‘Pf’ bacteriophages of Pseudomonas aeruginosa play roles in biofilm formation and virulence, but mechanisms governing Pf prophage activation in biofilms are unclear. Here, we identify a prophage regulatory module, KKP (kinase-kinase-phosphatase), that controls virion production of co-resident Pf prophages and mediates host defense against diverse lytic phages. KKP consists of Ser/Thr kinases PfkA and PfkB, and phosphatase PfpC. The kinases have multiple host targets, one of which is MvaU, a host nucleoid-binding protein and known prophage-silencing factor. Characterization of KKP deletion and overexpression strains with transcriptional, protein-level and prophage-based approaches indicates that shifts in the balance between kinase and phosphatase activities regulate phage production by controlling MvaU phosphorylation. In addition, KKP acts as a tripartite toxin-antitoxin system that provides defense against some lytic phages. A conserved lytic phage replication protein inhibits the KKP phosphatase PfpC, stimulating toxic kinase activity and blocking lytic phage production. Thus, KKP represents a phosphorylation-based mechanism for prophage regulation and antiphage defense. The conservation of KKP gene clusters in >1000 diverse temperate prophages suggests that integrated control of temperate and lytic phage infection by KKP-like regulatory modules may play a widespread role in shaping host cell physiology. The ‘Pf’ bacteriophages of Pseudomonas aeruginosa play roles in biofilm formation and virulence. Here, the authors identify a prophage regulatory module, KKP (kinase-kinase-phosphatase), that controls virion production of co-resident Pf prophages and mediates host defense against diverse lytic phages.

Background Late gadolinium enhancement cardiac magnetic resonance imaging (LGE-CMR) is a valuable cardiovascular imaging technique. Segmentation of cardiac chambers from LGE-CMR is a fundamental step in electrophysiological modeling and cardiovascular disease diagnosis. Deep learning methods have demonstrated extremely promising performance. However, excellent performance often depended on a large amount of finely annotated data. The purpose of this manuscript was to develop a semi-supervised segmentation method to use unlabeled data to improve model performance. Methods This manuscript proposed a semi-supervised network that integrates triple-consistency constraints (data-level, task-level, and feature-level) for cardiac chambers segmentation from LGE-CMR. Specifically, we designed a network that integrated segmentation and edge prediction tasks based on the mean teacher architecture. This addressed the problem of ignoring some challenging regions because of excluding low-confidence regions of previous research. We also applied a voxel-level contrastive learning strategy to achieve feature-level consistency, helping the model pay attention to the consistency between features overlooked in previous research. Results In terms of the Dice, Jaccard, Average Surface Distance (ASD), and 95% Hausdorff Distance (95HD) metrics, for the atrial segmentation dataset, the proposed method achieved scores of 88.34%, 79.30%, 7.92, and 2.02 when trained with 10% labeled data, and 90.70%, 83.09%, 6.41, and 1.72 when trained with 20% labeled data. For the ventricular segmentation task, the results were 87.22%, 77.95%, 2.27, and 0.61 with 10% labeled data, and 88.99%, 80.45%, 1.87, and 0.51 with 20% labeled data, respectively. Conclusion Experiments demonstrated that our method outperforms previous semi-supervised methods, showing the potential of the proposed network for semi-supervised segmentation problems.

Zearalenone is a contaminant in food and feed products. It has been reported that zearalenone could lead to serious damage to health. So far, it is unclear whether zearalenone could lead to cardiovascular aging–related injury. For this, we assessed the effect of zearalenone on cardiovascular aging. Cardiomyocyte cell lines and primary coronary endothelial cells were used as two cell models in vitro experiments, and Western-blot, indirect immunofluorescence, and flow cytometry were performed to study the effect of zearalenone on cardiovascular aging. Experimental results indicated zearalenone treatment increased Sa-β-gal positive cell ratio, and the expression of senescence markers (p16 and p21) was significantly upregulated. Additionally zearalenone upregulated the inflammation and oxidative stress in cardiovascular cells. Furthermore, the effect of zearalenone on cardiovascular aging was also evaluated in vivo, and the results indicated that zearalenone treatment also led to the aging of myocardial tissue. These findings suggest that zearalenone could lead to cardiovascular aging-related injury. Furthermore, we also preliminarily explored the potential effect of zeaxanthin (which is a powerful antioxidant) on zearalenone-caused aging-related damage in vitro cell model, and found that zeaxanthin could alleviate zearalenone-induced aging-related damage. Collectively, the most important finding of the current work is that zearalenone could lead to cardiovascular aging. Next in importance, we also found that zeaxanthin could partially alleviate zearalenone-induced cardiovascular aging in vitro, indicating that zeaxanthin can be used as a drug or functional food to treat cardiovascular damage caused by zearalenone.

Background Condom use at last intercourse is an effective indicator for human immunodeficiency virus (HIV) prevention. To identify at-risk individuals and improve prevention strategies, this study explored factors associated with condomless sex at last intercourse in the last year and developed a risk estimation model to calculate the individual possibility of condomless sex among college students in Zhuhai, China. Methods A cross-sectional study was conducted among 1430 college students who had sex in the last year from six universities in Zhuhai. The least absolute shrinkage and selection operator (LASSO) and logistic regression were performed to explore the predictors of condomless sex. The nomogram was constructed to calculate the individual possibility of condomless sex. Discrimination and calibration of the nomogram were evaluated using the area under the receiver-operator characteristic curve (AUROC) and the calibration curve. Results The proportion of students who had condomless sex at last intercourse was 18.2% (260/1430). Students who had experienced more types of intimate partner violence (aOR, 1.58; 95% CI, 1.31 ~ 1.92) and had anal sex (aOR, 1.75; 95% CI, 1.06 ~ 2.84) were more likely to have condomless sex. Students who had heterosexual intercourse (aOR, 0.37; 95% CI, 0.21 ~ 0.70), used condoms at first sex (aOR, 0.20; 95% CI, 0.14 ~ 0.27), had high attitudes towards condom use (aOR, 0.87; 95% CI, 0.80 ~ 0.95) and self-efficacy for condom use (aOR, 0.84; 95% CI, 0.78 ~ 0.90) were less likely to have condomless sex. The nomogram had high accuracy with an AUROC of 0.83 and good discrimination. Conclusions Intimate partner violence, anal sex, condom use at first sex, attitude towards condom use, and self-efficacy for condom use were associated with condomless sex among college students. The nomogram was an effective and convenient tool for calculating the individualized possibility of condomless sex among college students. It could help to identify individuals at risk and help universities and colleges to formulate appropriate individualized interventions and sexual health education programs.

Background Understanding factors associated with antiretroviral treatment (ART) adherence is crucial for ART success among people living with HIV (PLHIV) in the “test and treat” era. Multiple psychosocial factors tend to coexist and have a syndemic effect on ART adherence. We aimed to explore factors associated with ART adherence and the syndemic effect of multiple psychosocial factors on ART adherence among PLHIV newly starting ART in Guangdong Province, China. Methods Newly diagnosed PLHIV from six cities in Guangdong Province were recruited between May 2018 and June 2019, and then followed up from May 2019 to August 2020. Baseline and follow-up data were collected from a questionnaire and the national HIV surveillance system, the follow-up data of which were analyzed in this study. A Center for Adherence Support Evaluation (CASE) index > 10 points was defined as optimal ART adherence, which was measured via participants’ self-reported adherence during follow-up survey. Multivariable logistic regression was used to identify factors associated with ART adherence. Exploratory factor analysis (EFA) and multi-order latent variable structural equation modeling (SEM) were performed to explore the syndemic effect of multiple psychosocial factors on ART adherence. Results A total of 734 (68.53%) follow-up participants were finally included in this study among the 1071 baseline participants, of whom 91.28% (670/734) had self-reported optimal ART adherence. Unemployment (aOR = 1.75, 95%CI: 1.01–3.02), no medication reminder (aOR = 2.28, 95%CI: 1.09–4.74), low medication self-efficacy (aOR = 2.28, 95%CI: 1.27–4.10), low social cohesion (aOR = 1.82, 95%CI: 1.03–3.19), no social participation (aOR = 5.65, 95%CI: 1.71–18.63), and ART side effects (aOR = 0.46, 95%CI: 0.26–0.81) were barriers to optimal ART adherence. The EFA and second-order latent variable SEM showed a linear relationship (standardized coefficient = 0.43, P  < 0.001) between ART adherence and the latent psychosocial (syndemic) factor, which consisted of the three latent factors of medication beliefs and self-efficacy (standardized coefficient = 0.65, P  < 0.001), supportive environment (standardized coefficient = 0.50, P  < 0.001), and negative emotions (standardized coefficient=-0.38, P  < 0.01). The latent factors of medication beliefs and self-efficacy, supportive environment, and negative emotions explained 42.3%, 25.3%, and 14.1% of the variance in the latent psychosocial factor, respectively. Conclusions About nine out of ten PLHIV on ART in Guangdong Province self-reported optimal ART adherence. However, more efforts should be made to address barriers to optimal ART adherence.